子痫前期孕妇血清白细胞介素17、和肽素及血小板内皮细胞黏附分子1水平检测及临床意义

Detection and significance of serum IL-17,CPT and PECAM-1 in pregnant women with preeclampsia

目的:探究血清白细胞介素17(IL-17)、和肽素(CPT)及血小板内皮细胞黏附分子1(PECAM-1)水平与子痫前期孕妇病情的相关性。方法:选取子痫前期孕妇100例(试验组)作为研究对象,其中有轻度子痫前期孕妇55例(轻度组)和重度子痫前期孕妇45例(重度组),另选同期进行体检的健康孕妇80例作为对照组。采用酶联免疫吸附法检测所有受试者血清IL-17、CPT和PECAM-1水平,采用Logistic回归分析孕妇发生子痫前期的影响因素,采用受试者工作特征(ROC)曲线分析血清IL-17、CPT和PECAM-1水平对子痫前期的诊断价值。结果:试验组患者血清IL-17、CPT水平均明显高于对照组,PECAM-1水平低于对照组,差异有统计学意义(P<0.05);重度组患者血清IL-17、CPT水平均明显高于轻度组,PECAM-1水平低于轻度组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,IL-17升高的OR值为1.265(95%CI:0.981~1.556,P<0.001),CPT升高的OR值为2.330(95%CI:1.924~2.703,P<0.001),PECAM-1降低的OR值为2.071(95%CI:1.613~2.498,P<0.001);IL-17升高、CPT升高和PECAM-1降低均与孕妇发生子痫前期相关,是孕妇发生子痫前期的独立危险因素;由ROC曲线分析结果显示,检测IL-17以55.61 pg/ml为截断值时,敏感度为83.00%,特异度为53.75%,准确度为70.00%;检测CPT以0.61 ng/ml为截断值时,敏感度为84.00%,特异度为65.00%,准确度为75.56%;检测PECAM-1以110.61 ng/L为截断值时,敏感度为74.00%,特异度为61.25%,准确度为68.33%;IL-17+CPT+PECAM-1联合检测以54.35 pg/ml+0.52 ng/ml+112.48 ng/L为截断值时,敏感度为93.00%,特异度为87.50%,准确度为90.56%;IL-17+CPT+PECAM-1联合检测的敏感度、特异度及准确度明显高于IL-17、CPT及PECAM-1单独检测,差异有统计学意义(P<0.05)。结论:血清IL-17、CPT和PECAM-1水平与孕妇子痫前期的发生、发展具有相关性,是孕妇发生子痫前期的危险因素,可作为诊断孕妇子痫前期的血清标志物,且IL-17+CPT+PECAM-1联合检测可有效提高孕妇子痫前期诊断的准确性。

Objective:To investigate the relationship between the serum levels of Interleukin 17(IL-17),Copeptin(CPT) and platelet endothelial cell adhesion molecule 1(PECAM-1) and the condition of preeclampsia.Methods:100 cases of preeclampsia pregnant women(experimental group) were selected as the study objects,including 55 cases of mild preeclampsia pregnant women(mild group) and 45 cases of severe preeclampsia pregnant women(severe group).80 cases of healthy pregnant women who had physical examination at the same time were selected as the control group.The serum levels of IL-17,CPT and PECAM-1 were detected by enzyme-linked immunosorbent assay.The influencing factors of preeclampsia were analyzed by Logistic regression.The diagnostic value of serum IL-17,CPT and PECAM-1 in preeclampsia was analyzed by ROC curve.Results:The serum levels of IL-17 and CPT in the experimental group were significantly higher than those in the control group,and the level of PECAM-1 was significantly lower than that in the control group(P<0.05).The serum levels of IL-17 and CPT in the severe group were significantly higher than those in the mild group,and the level of PECAM-1 was lower than that in the mild group(P<0.05).Logistic regression analysis showed that the OR value of IL-17 was 1.265(95%CI 0.981-1.556,P<0.001),the OR value of CPT was 2.330(95%CI 1.924-2.703,P<0.001),the OR value of PECAM-1 was 2.071(95%CI 1.613-2.498,P<0.001);the increase of IL-17 and CPT,the decrease of PECAM-1,were all related to the occurrence of preeclampsia in pregnant women,which were the independent risk factors of preeclampsia in pregnant women.The ROC curve analysis results showed that when 55.61 pg/ml was used as the cutoff value,the sensitivity,specificity and accuracy of IL-17 were 83.00%,53.75% and 70.00%,respectively;when 0.61 ng/ml was used as the cutoff value,the sensitivity,specificity and accuracy of CPT were 84.00%,65.00% and 75.56%,respectively;when 110.61 ng/L was used as the cutoff value,the sensitivity,specificity and accuracy of PECAM-1 were 74.00%,61.25% and 68.33%,respectively;when 54.35 pg/ml(IL-17)+0.52 ng/ml(CPT)+112.48 ng/L(PECAM-1) was used as the cutoff value,the sensitivity,specificity and accuracy of the combined detection were 93.00%,87.50% and 90.56% respectively,which was significantly higher than those of IL-17,CPT and PECAM-1 alone(P<0.05).Conclusion:The levels of serum IL-17,CPT and PECAM-1 are correlated with the occurrence and development of preeclampsia.They are the risk factors of preeclampsia in pregnant women and can be used as serum markers for the diagnosis of preeclampsia.The combined detection of IL-17,CPT and PECAM-1 can effectively improve the accuracy of the diagnosis of preeclampsia in pregnant women.