妊娠期高血压疾病患者血清E_(2)、E_(2)-FAE水平与不良妊娠结局的相关性

Correlation between serum E_(2), E_(2)-FAE levels and adverse pregnancy outcomes in patients with hypertensive disorder complicating pregnancy

目的观察妊娠期高血压疾病(HDCP)患者血清雌二醇(E_(2))、雌激素脂肪酯(E_(2)-FAE)表达,分析E_(2)、E_(2)-FAE水平与HDCP不良妊娠结局的关系。方法选取2017年5月至2019年12月新疆维吾尔自治区人民医院成功分娩的143例HDCP患者的临床资料作为研究对象,将其作为实验组。收集同期成功分娩且经相关检查排除妊娠期高血压的139例产妇的临床资料作为对照组。实验组根据妊娠结局的不同分为不良组与良好组,检测并比较各组血清E_(2)、E_(2)-FAE水平;分析血清E_(2)、E_(2)-FAE水平之间的相关性;检验血清E_(2)、E_(2)-FAE对HDCP患者不良妊娠结局的影响及其对不良妊娠结局的风险预测价值。结果实验组血清E_(2)及E_(2)-FAE水平低于对照组(P<0.05);实验组143例HDCP患者中,发生不良妊娠结局15例(10.49%);不良组血清E_(2)、E_(2)-FAE水平低于良好组(P<0.05);相关性分析显示,HDCP患者血清E_(2)水平与血清E_(2)-FAE水平呈正相关(r>0,P<0.05);回归分析与受试者操作特征(ROC)曲线显示,血清E_(2)、E_(2)-FAE低表达是HDCP患者不良妊娠结局的影响因素(OR>1,P<0.05),二者预测不良妊娠结局风险的曲线下面积(AUC)分别为0.895、0.860,均>0.85,预测价值较理想。结论 HDCP患者普遍存在不同程度血清E_(2)、E_(2)-FAE低表达,可能提示患者存在不良妊娠结局风险,临床可考虑通过检测HDCP患者血清E_(2)、E_(2)-FAE水平,来预测患者不良妊娠结局发生风险,指导早期评估与防治。

Objective To observe the expression of serum estradiol(E_(2)) and estradiol fatty acid esters(E_(2)-FAE) in patients with hypertensive disorder complicating pregnancy(HDCP), and analyze the relationship between E_(2), E_(2)-FAE levels and adverse pregnancy outcomes of HDCP. Methods 143 HDCP patients who delivered successfully in Xinjiang Uygur Autonomous Region People′s Hospital from May 2017 to December 2019 were selected as the experimental group. 139 parturients without HDCP who delivered successfully during the same period were collected as control group. According to different pregnancy outcomes, the experimental group was divided into adverse pregnancy outcome group and non-adverse pregnancy outcome group according to the pregnancy outcomes. Serum levels of E_(2) and E_(2)-FAE in each group were measured and compared. The correlation between serum levels of E_(2) and E_(2)-FAE was analyzed, to investigate the effects of serum E_(2) and E_(2)-FAE on adverse pregnancy outcomes in HDCP patients and their risk prediction value. Results The serum E_(2) and E_(2)-FAE levels in experimental group were lower than those in control group(P<0.05);There were 15 cases of adverse pregnancy outcome in 143 patients with HDCP;The levels of serum E_(2) and E_(2)-FAE in adverse pregnancy outcome group were lower than those in non-adverse pregnancy outcome group(P<0.05);Correlation analysis showed that serum E_(2) level was positively correlated with serum E_(2)-FAE level in HDCP patients(r>0, P<0.05);Regression analysis and ROC curve showed that low expression of serum E_(2) and E_(2)-FAE was the influencing factor of adverse pregnancy outcome in patients with HDCP(OR>1, P<0.05), and the AUC of serum E_(2) and E_(2)-FAE in predicting the adverse pregnancy outcome were 0.895, 0.860, which were greater than 0.85, and the predictive value was ideal. Conclusions Patients with HDCP generally have low expression of serum E_(2) and E_(2)-FAE, which may indicate that patients have a risk of adverse pregnancy outcome. Clinically, the detection of serum E_(2) and E_(2)-FAE levels in patients with HDCP may be considered to predict the risk of adverse pregnancy outcome, to guide early assessment and prevention.