CA-125在子痫前期孕妇中异常升高及对可逆性白质脑病综合征的影响与影像学特点

Abnormal elevation of CA-125 in pregnant women with preeclampsia and its effect on reversible leukoencephalopathy syndrome

目的研究CA-125在子痫前期中的水平变化及可逆性白质脑病综合征的发生情况分析。方法选择2018年1月~2019年12月期间我院收治的40例轻度子痫前期孕妇、40例重度子痫前期孕妇,以及40例正常健康孕妇作为研究对象,比较各组见孕妇外周血CA-125的水平差异,评价CA-125用于预测子痫前期的发病的价值,分析所有患者脑MRI的情况特点,比较子痫前期孕妇中CA-125水平和可逆性白质脑病综合征发生率关系。结果 3组孕妇外周血CA-125水平比较,重度组子痫前期孕妇最高(69.25±25.70 U/mL),其次为轻度子痫前期组孕妇(44.40±20.69 U/mL),健康组孕妇最低(22.58±9.32 U/mL),3组差异有统计学意义(F=55.684,P<0.001)。外周血CA-125用于预测子痫前期的发病,ROC曲线下面积为0.873(95%CI:0.812-0.934,P<0.05);80例孕妇中有7例患者出现可逆性白质脑病综合征,其中重度子痫前期孕妇中6例,轻度子痫前期孕妇中1例。CA-125高水平组与CA-125低水平组孕妇可逆性白质脑病综合征发生率差异有统计学意义(χ^2=9.774,P<0.05)。结论 CA-125在子痫前期孕妇中水平增高,且病情越重,水平越高,CA-125可作为子痫前期发病的预测指标,并且CA-125高水平提高了可逆性白质脑病综合征的发生率。

Objective To study the level change of CA-125 in preeclampsia and the occurrence of reversible leukoencephalopathy syndrome. Methods 40 pregnant women with mild preeclampsia, 40 pregnant women with severe preeclampsia and 40 healthy pregnant women admitted to our hospital from January 2018 to December 2019 were selected as subjects, then compare the levels of CA-125 in peripheral blood of pregnant women in each group and evaluate the value of CA-125 in predicting the onset of preeclampsia. The characteristics of brain MRI in all patients were analyzed and the relationship between CA-125 level and the incidence of reversible leukoencephalopathy syndrome in preeclampsia pregnant women was compared. Results The level of CA-125 in peripheral blood of pregnant women in the three groups was higher in the severe preeclampsia group(69.25±25.70 U/mL) than in the mild preeclampsia group(44.40±20.69 U/mL), and lowest in the healthy group(22.58±9.32 U/mL). There was a significant difference between the three groups(F=55.684, P<0.001). Use peripheral blood CA-125 to predict the onset of preeclampsia, and the AUC was 0.873(95% CI: 0.812-0.934, P<0.05);A total of 7 out of 80 pregnant women developed reversible leukoencephalopathy syndrome, including 6 women with severe preeclampsia and 1 woman with mild preeclampsia. The incidence of reversible leukoencephalopathy syndrome in pregnant women was significantly different between the high-level group of CA-125 and the low-level group of CA-125(χ^2=9.774, P<0.05).Conclusion The level of CA-125 is significantly higher in pregnant women with preeclampsia, and the more severe the condition, the higher the level. CA-125 can be used as a predictor of the onset of preeclampsia, and the high level of CA-125 increases the incidence of reversible leukoencephalopathy syndrome.