子痫前期患者血清CXCL16、FGF21表达水平及临床意义

Expression and clinical significance of serum CXCL16 and FGF 21 in patients with preeclampsia

目的探讨血清CXC趋化因子配体16(CXC chemokine ligand 16,CXCL16)、成纤维细胞生长因子21(fibroblast growth factor 21,FGF21)对子痫前期的诊断及病情严重程度评估的临床价值。方法选取2016年6月至2019年4月航天中心医院妇产科诊治的241例子痫前期患者作为研究对象,根据病情分为轻度子痫前期患者(轻度组,137例)和重度子痫前期患者(重度组,104例);同时选取同期65例产检的健康孕妇作为对照组。检测血清CXCL16、FGF21和肾功能指标水平,应用ROC曲线分析血清CXCL16、FGF21对子痫前期患者的诊断及病情严重程度评价的临床价值。结果三组血清CXCL16、FGF21、肌酐(Scr)、尿素(BUN)和血清胱抑素C(Cys C)水平比较,差异有统计学意义(P<0.05)。轻度组和重度组血清CXCL16、FGF21、Scr、BUN和Cys C水平高于对照组,而轻度组血清CXCL16、FGF21、Scr、BUN和Cys C水平低于重度组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,血清CXCL16、FGF21诊断子痫前期患者曲线下面积(AUC)分别为0.822、0.863,当截断值为1.48和162.22 pg/mL时,敏感度分别为80.08%、80.91%,特异度分别为73.81%、80.01%;两者联合时AUC为0.910,敏感度为82.16%,特异度为87.69%。血清CXCL16、FGF21评价子痫前期患者病情严重程度AUC分别为0.833、0.851,当截断值为2.90和206.01 pg/mL时,敏感度分别为83.65%、86.54%,特异度分别为81.75%、70.07%;两者联合时AUC为0.938,敏感度为87.50%,特异度为91.24%。结论子痫前期患者血清CXCL16、FGF21和肾功能指标水平升高,可作为诊断及评价子痫前期患者病情严重程度的标志物,但两者联合应用的价值优于单独应用。

ObjectiveTo investigate the expression and clinical significance of serum CXC chemokineligand 16(CXCL16)and fibroblast growth factor 21(FGF21)in patients with preeclampsia.MethodsFromJune 2016 to April 2019,241 patients with preeclampsia were selected which were divided into mild preeclampsiapatients(mild group,137 cases)and severe preeclampsia patients(severe group,104 cases).And 65 healthypregnant women were selected as control group.Serum levels of CXCL16,FGF21 and renal function weremeasured.The ROC curve were used to analyze the value of serum CXCL16 and FGF21 in the diagnosis andevaluation of the severity of preeclampsia.ResultsThere were significant differences in serum CXCL16,FGF21,Scr,BUN and Cys C levels among the three groups(P<0.05).Serum CXCL16,FGF21,Scr,BUN and Cys Clevels in mild group and severe group were higher than those of control group(P<0.05),while serum CXCL16,FGF21,Scr,BUN and Cys C levels in mild group were lower than those of severe group(P<0.05).The results ofROC curve analysis showed that AUC of CXCL16 and FGF21 in the diagnosis of preeclampsia were 0.822 and0.863 respectively.When the cutoff value were 1.48 pg/mL and 162.22 pg/mL,the sensitivity were 80.08%and80.91%,and the specificity were 73.81%and 80.01%respectively.When serum CXCL16 and FGF21 werecombined,the AUC was 0.910,the sensitivity was 82.16%,and the specificity was 87.69%.The AUC of serumCXCL16 and FGF21 in evaluating the severity of preeclampsia were 0.833 and 0.851 respectively.When the cutoffvalue were 2.90 pg/mL and 206.01 pg/mL,the sensitivity were 83.65%and 86.54%,and the specificity were81.75%and 70.07%respectively.When serum CXCL16 and FGF21 were combined,the AUC was 0.938,thesensitivity was 87.50%,and the specificity was 91.24%.ConclusionSerum CXCL16,FGF 21 and renalfunction in patients with preeclampsia are elevated,which could be used as markers to diagnose and evaluate theseverity of preeclampsia,but their combined application value are better than those of single application.