超声子宫动脉搏动指数联合血清HMGB1、sCD40L对子痫前期孕妇的预测价值

Value of uterine artery Doppler pulsatility index combined with serum HMGB1 and sCD40L in predicting preeclampsia

目的:探讨超声子宫动脉搏动指数(PI)联合血清高迁移率族蛋白B1(HMGB1)、可溶性细胞分化抗原(sCD40L)对子痫前期(PE)孕妇的预测价值。方法:回顾性分析我院2018年1月—2019年10月收治的PE孕妇95例为观察组,根据病情严重程度不同分为轻度组(n=53例)、重度组(n=42例)。另选取同期于我院体检健康孕妇40例为对照组。所有人均经子宫动脉多普勒超声检查,并经酶联免疫吸附法检测血清HMGB1、sCD40L表达水平。比较各组PI、血清HMGB1、sCD40L水平。采用Spearman相关性分析PI联合血清HMGB1、sCD40L与PE病情严重程度的关系,采用ROC曲线分析PI联合血清HMGB1、sCD40L对PE的诊断价值。结果:观察组PI及血清HMGB1、sCD40L水平均明显高于对照组(P<0.05);重度组患者PI及血清HMGB1、sCD40L水平均明显高于轻度组(P<0.05);PI及血清HMGB1、sCD40L与PE病情严重程度均呈正相关(r=0.554、0.417、0.423,P<0.05);经ROC曲线分析,当PI取值1.13时,预测PE的AUC为0.704,灵敏度为57.9%,特异度为80.0%;HMGB1取值292.92 ng/L时,预测PE的AUC为0.850,灵敏度为89.5%,特异度为80.0%;sCD40L取值5.46μg/L时,预测PE的AUC为0.700,灵敏度为74.7%,特异度为70.0%;三项指标联合预测PE的AUC为0.916,灵敏度为98.9%,特异度为80.0%。结论:超声子宫动脉PI联合血清HMGB1、sCD40L评估和预测PE孕妇具有较高临床应用价值。

Objective:To investigate the value of ultrasound uterine artery pulsatility index(PI)combined with serum high mobility group protein B1(HMGB1)and soluble cluster of differentiation antigen 40 ligand(sCD40 L)in predicting preeclampsia(PE).Methods:Ninety-five PE women and 40 healthy women in our hospital from January 2018 to October 2019 were retrospectively analyzed,and set as observation group and control group,respectively.Observation group was further divided into two subgroups according to the severity degrees,mild group(n=53)and severe group(n=42).Doppler ultrasound of the uterine artery was performed among all selected individuals.Serum HMGB1 and sCD40 L expression levels were detected by enzymelinked immunosorbent assay.All those indicators were compared between groups.Spearman correlation was used to analyze the correlation between PI,HMGB1,sCD40 L and the severity of PE,and ROC curve was used to analyze the diagnostic value of PI combined with serum HMGB1 and sCD40 L for PE.Results:PI,serum HMGB1 and sCD40 L levels of observation group were significantly higher than those of control group(P<0.05).PI,serum HMGB1 and sCD40 L levels of severe group were significantly higher than those of mild group(P<0.05).PI,serum HMGB1 and sCD40 L were positively correlated with the severity of PE(r=0.554,0.417,0.423,P<0.05).When the value of PI,HMGB1 and sCD40 L was 1.13,292.92 ng/L,and 5.46μg/L,ROC curve showed that the AUC of the three indicators in predicting PE was 0.704,0.850 and 0.700,respectively,with a sensitivity of 57.9%,89.5%and 74.7%,and a specificity of 80.0%,80.0%and 70.0%,respectively.Meanwhile,the combined detection of the three had higher AUC,sensitivity and specificity in the prediction of PE than those of single detection,being0.916,98.9%and 80.0%.Conclusion:Examination of ultrasound uterine artery PI combined with serum HMGB1 and sCD40 L has high clinical value in predicting PE.