子痫前期孕妇血清Gas6、SDF-1水平变化及其临床意义

Changes in levels of serum Gas 6 and SDF-1 in preeclampsia pregnant women and its clinical significance

目的探讨子痫前期患者血清生长停滞特异性蛋白6(Gas6)、基质细胞衍生因子1(SDF-1)水平变化及其临床意义。方法选择子痫前期孕妇153例(观察组),其中轻度62例、重度91例,同期选择正常单胎妊娠孕妇80例(对照组),采集两组肘静脉血,检测血清Gas6、SDF-1及炎症因子IL-6、IL-1β、IL-17、TNF-α、高敏C反应蛋白(hs-CRP)、单核细胞趋化蛋白1(MCP-1),分析子痫前期患者血清Gas6、SDF-1水平与血清炎症因子水平的关系,采用受试者工作特征(ROC)曲线评估血清Gas6、SDF-1单独和联合检测诊断子痫前期的价值。结果观察组血清Gas6水平明显高于对照组,血清SDF-1水平明显低于对照组(P均<0.05);重度子痫前期患者血清Gas6水平明显高于轻度子痫前期患者,血清SDF-1水平明显低于轻度子痫前期患者(P均<0.05);观察组血清IL-6、IL-1β、IL-17、TNF-α、hs-CRP、MCP-1水平均明显高于对照组,且重度子痫前期患者血清IL-6、IL-1β、IL-17、TNF-α、hs-CRP、MCP-1水平均明显高于轻度子痫前期患者(P均<0.05)。Pearson积矩相关分析显示,子痫前期患者血清Gas6水平与血清IL-6、IL-1β、IL-17、TNF-α、hs-CRP、MCP-1水平均呈正相关关系,血清SDF-1水平与血清IL-6、IL-1β、IL-17、TNF-α、hs-CRP、MCP-1水平均呈负相关关系(P均<0.05)。ROC曲线分析显示,血清Gas6、SDF-1联合检测诊断子痫前期的曲线下面积明显高于血清Gas6、SDF-1单独检测(P均<0.05)。结论子痫前期患者血清Gas6水平升高、血清SDF-1水平降低,二者均与病情程度密切相关;血清Gas6、SDF-1可能通过介导机体炎症反应协同参与子痫前期发病过程。早期联合检测血清Gas6、SDF-1有助于子痫前期诊断和病情评估。

Objective To investigate the changes of serum growth arrest specific protein 6(Gas6)and stromal cell derived factor 1(SDF-1)levels in patients with preeclampsia and their clinical significance.Method Totally 153 pregnant women with preeclampsia(observation group),including 62 mild cases and 91 severe cases,and 80 normal pregnant women with singleton pregnancy(control group)were selected in the same period.Blood samples were collected from elbow vein to detect the serum Gas6,SDF-1,inflammatory factors IL-6,IL-1β,IL-17,tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP),and monocyte chemoattractant protein-1(MCP-1).The relationships between serum Gas6 and SDF-1 and serum inflammatory factors were analyzed.The receiver operating characteristic(ROC)curve was used to assess the value of detecting serum Gas6 and SDF-1 alone and in combination for the diagnosis of preeclampsia.Results The serum Gas6 in the observation group was significantly higher than that in the control group,the serum SDF-1 level was significantly lower than that in the control group,the serum Gas6 level in the severe preeclampsia patients was significantly higher than that in the mild preeclampsia patients,and the serum SDF-1 level was significantly lower than that in the mild preeclampsia patients(all P<0.05).The serum levels of IL-6,IL-1β,IL-17,TNF-α,hs-CRP,and MCP-1 in the observation group were significantly higher than those in the control group,and the serum levels of IL-6,IL-1β,IL-17,TNF-α,hs-CRP,and MCP-1 in the severe preeclampsia patients were significantly higher than those in the mild preeclampsia patients(all P<0.05).Pearson product moment correlation analysis showed that the serum Gas6 was positively correlated with serum IL-6,IL-1β,IL-17,TNF-α,hs-CRP and MCP-1 levels in the preeclampsia patients,while the serum SDF-1 was negatively correlated with serum IL-6,IL-1β,IL-17,TNF-α,hs-CRP and MCP-1 levels(all P<0.05).ROC curve analysis showed that the combined detection of serum Gas 6 and SDF-1 in diagnosis of preeclampsia was significantly higher than that of serum Gas6 and SDF-1 alone(both P<0.05).Conclusions The serum Gas6 increases and SDF-1 decreases in patients with preeclampsia,which are closely related to the severity of the disease.Both of them participate in the pathogenesis of pre-eclampsia through mediating the inflammatory response of the body,and the early combined detection of serum Gas6 and SDF-1 is helpful for the diagnosis and evaluation of preeclampsia.