子痫前期患者血清代谢物水平及其与疾病严重程度的相关性研究

Study on serum metabolite level and its correlation with disease severity in patients with preeclampsia

目的检测子痫前期患者血清中的代谢物水平,并探讨其与疾病严重程度的相关性及联合检测对重度子痫前期患者的诊断价值。方法选取2019年5-12月在青岛大学附属医院就诊的子痫前期患者40例作为观察组,包括轻度子痫前期患者20例,重度子痫前期患者20例,同时另选取同期健康妊娠孕妇20例为对照组。采用基于液相色谱-串联质谱(LC-MS/MS)的代谢组学研究技术,分别对各组孕妇血清中5种代谢物的水平进行测定,利用Analyst1.6.3质谱数据处理软件分析处理得出数据,采用单因素方差分析、t检验、秩和检验和Spearman相关性分析,对数据进行统计学分析,采用受试者工作特征曲线(ROC曲线)分析血清甜菜碱、脯氨酸、1-硬脂酰-sn-甘油-3-磷酰胆碱(LPC18:0)及联合检测对重度子痫前期患者的诊断效能。结果观察组血清LPC18:0水平高于对照组,差异有统计学意义(P<0.05)。重度子痫前期组血清甜菜碱、脯氨酸水平低于轻度子痫前期组、对照组,差异有统计学意义(P<0.05);重度子痫前期组、轻度子痫前期组血清LPC18:0水平均高于对照组,差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,血清甜菜碱与子痫前期的病情程度呈负相关(r=-0.317,P<0.05),血清LPC18:0与子痫前期的病情程度呈正相关(r=0.618,P<0.05);血清甜菜碱、脯氨酸、LPC18:0联合检测重度子痫前期患者的ROC曲线下面积为0.907,灵敏度为85%,特异度为90%,具有较高的诊断价值。结论子痫前期患者随着病情加重,血清甜菜碱、LPC18:0水平与子痫前期病情程度具有一定的相关性,血清甜菜碱、脯氨酸、LPC18:0联合检测对重度子痫前期患者诊断具有较高的诊断价值。

Objective To detect the levels of serum metabolites in patients with preeclampsia,explore the correlations with severity of preeclampsia.and the diagnostic value of combined detection in severe preeclampsia.Methods From May to December 2019,40 cases of preeclampsia who were admitted in the affiliated hospital of Qingdao university were selected as the observation group,including 20 patients with mild preeclampsia and 20 patients with severe preeclampsia,meanwhile,20 normal pregnant women of the same period were selected as the control group.Liquid chromatography-tandem mass spectrometry(LC-MS/MS)was used to determine the five metabolites in the serum of three groups of pregnant women.The data were analyzed and processed by Analyst1.6.3 mass spectrometry data processing software.The data were statistically analyzed by One-way analysis of variance,t-test,rank sum test and Spearman.The diagnostic efficacy of serum betaine,proline,1-stearoyl-sn-glycero-3-phosphocholine(LPC18:0)and combined detection in severe preeclampsia was analyzed by receiver operating characteristic curve(ROC curve).Results The level of serum LPC18:0 in observation group was higher than that in control group,and the difference was statistically significant(P<0.05).Serum betaine and proline levels in severe preeclampsia group were lower than those in mild preeclampsia group and control group,with statistical significance(P<0.05).The level of serum LPC18:0 in severe preeclampsia group and mild preeclampsia group was higher than that in control group,and the difference was statistically significant(P<0.05).Spearman correlation analysis showed that the Serum of betaine was negatively correlated with severity of preeclampsia(r=-0.317,P<0.05).The serum of LPC18:0 was positively correlated with severity of preeclampsia(r=0.618,P<0.05).The area under ROC curve of serum betaine,proline and LPC18:0 was 0.907,the sensitivity was 85%,the specificity was 90%,and it had high diagnostic value.Conclusion With the exacerbation of preeclampsia,the level of serum betaine and LPC18:0 is correlated with the severity of preeclampsia.The combined detection of serum betaine,proline and LPC18:0 is of high diagnostic value in the diagnosis of severe preeclampsia.