妊娠期高血压患者血清MCP-1、PECAM-1、组织因子表达及临床意义

Expression and clinical significance of serum monocyte chemoattractant protein-1,platelet endothelial cell adhesion molecule-1,and tissue factor in women with pregnancy-induced hypertension syndrome

目的:检测妊娠期高血压(PIH)患者血清单核细胞趋化蛋白-1(MCP-1)、血小板内皮细胞黏附分子-1(PECAM-1)、组织因子(TF)表达水平及与凝血指标关系。方法:以2018年3月-2021年1月本院PIH孕妇200例(PIH组),正常妊娠孕妇200例为对照组,将PIH孕妇分为妊娠期高血压、轻度子痫前期、重度子痫前期。酶联免疫吸附试验检测各组血清中MCP-1、PECAM-1、TF水平;全自动血凝仪检测血浆中凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fg)和D-二聚体(D-D)。Pearson分析PIH孕妇血清MCP-1、PECAM-1、TF与血浆各凝血指标相关性。结果:与对照组比较,PIH组血清MCP-1、TF水平、血浆Fg、D-D水平升高,血清PECAM-1水平降低,血浆PT、APTT、TT缩短(P<0.05);与妊娠期高血压相比,轻度子痫前期、重度子痫前期血清MCP-1、TF水平、血浆Fg水平升高,血清PECAM-1水平降低,血浆APTT、TT缩短,重度子痫前期血浆中D-D水平升高,与轻度子痫前期相比,重度子痫前期血清MCP-1、TF水平,血浆Fg水平升高,血清PECAM-1水平降低,血浆APTT、TT缩短(均P<0.05)。PIH孕妇血清MCP-1、TF与血浆APTT、TT呈负相关,与Fg、D-D呈正相关,PECAM-1与血浆APTT、TT呈正相关,与Fg、D-D呈负相关(均P<0.05);血清MCP-1、TF与PECAM-1呈负相关,MCP-1与TF呈正相关(均P<0.05)。结论:PIH患者血清MCP-1、TF高表达,PECAM-1低表达,且随疾病加重变化增加,3者关系密切且均与凝血指标相关,可能在临床有一定诊断价值。

Objective:To detect the serum monocyte chemoattractant protein-1(MCP-1),platelet endothelial cell adhesion molecule-1(PECAM-1),and tissue factor(TF)expression levels of pregnant women with pregnancy-induced hypertension syndrome(PIH),and to analyze their relationship with the coagulation indicators levels of the women.Methods:From March 2018 to January 2021,200 pregnant women with PIH were selected in research group.During the same period,200 normal pregnant women were selected in control group.The women in the research group were further divided into group A(women with hypertension),group B(women with mild preeclampsia),and group C(women with severe preeclampsia).Enzyme-linked immunosorbent assay(ELISA)was used to detect the serum levels of MCP-1,PECAM-1,and TF of the women in these groups,and automatic coagulometer was used to detect the levels of prothrombin time(PT),activated partial prothrombin time(APTT),thrombin time(TT),fibrinogen(Fg),and D-dimer(D-D)in plasma of the women in these groups.Pearson analysis was used to analyze the correlation between the levels of serum MCP-1,and PECAM-1 of the women with PIH and their plasma PT,APTT,TT,Fg,and D-D levels.Results:Compared with those of the women in the control group,the serum MCP-1 and TF levels,plasma FG and D-D levels of the women in the research group were significant higher,but the serum PECAM-1 level and the plasma PT,APTT and TT levels were significant lower(P<0.05).Compared with those of the women in group A,the serum MCP-1 and TF,and plasma FG level of the women in group B and C,and the plasma D-D level of the women in group C were significant higher,but the levels of serum PECAM-1,and plasma APTT and TT of the women in group B and C were significant lower(P<0.05).Compared with those of the women in group B,the levels of serum MCP-1 and TF,and plasma FG of the women in group C were significant higher,but the serum PECAM-1 level,and the plasma APTT and TT values of the women in group C were significant lower(all P<0.05).In the research group,serum MCP-1 and TF levels of the women were negatively correlated with their plasma APTT and TT values,and were positively correlated with their Fg and D-D levels.The PECAM-1 level of the women in the research group was positively correlated with their plasma APTT and TT levels,and was negatively correlated with their FG and D-D levels(all P<0.05).The serum MCP-1 and TF of the women in the research group were negatively correlated with their PECAM-1 level,and their MCP-1 level was positively correlated with their TF level(all P<0.05).Conclusion:The serum levels of MCP-1 and TF of the women with PIH are high,while the PECAM-1 level is low,and the changes of which increase as PIH worsen.The levels of MCP-1,TF and PECAM-1 of the women with PIH are closely related each other,and all of them are also related to the coagulation indicators levels of the women,so which may have certain diagnostic value in clinical practice.