孕妇血清亲环素A和组织型转谷氨酰胺酶水平检测与子痫前期发生不良妊娠的相关性研究

Correlation Research between Serum Levels of Cyclophilin A as Well as Tissue Transglutaminase in Pregnant Women and Adverse Pregnancy in Preeclampsia

目的探讨孕妇血清亲环素A(cyclophilin A,CYPA)和组织型转谷氨酰胺酶(tissue transglutaminase,tTG)水平的变化与子痫前期(preeclampsia,PE)发生不良妊娠的相关性。方法选择2018年1月~2020年1月在咸阳市第一人民医院和西安市第一医院就诊的112例PE孕妇作为研究对象,依据妊娠结局分为正常妊娠组(85例)和不良妊娠组(27例),另选取51例同期体检健康孕妇作为对照组。采用酶联免疫吸附法(ELISA)检测血清CYPA和tTG水平,采用免疫比浊法检测24h尿蛋白水平,通过彩色多普勒超声检查获得所有研究对象的子宫动脉血流阻力参数,包括搏动指数(pulsatility index,PI)和阻力指数(resistance index,RI)。收集所有研究对象的血压等临床资料,比较分析以上指标的变化与PE孕妇发生不良妊娠的相关性。结果对照组、正常妊娠组和不良妊娠组血清CYPA和tTG水平分别为59.16±9.71,79.50±13.91,96.18±17.25ng/L和7.21±1.13,10.68±1.67,13.35±2.35ng/ml。与对照组比较,正常妊娠组和不良妊娠组的tTG和CYPA水平明显增高,其中不良妊娠组增高更显著,差异均有统计学意义(F=59.286~100.061,均P=0.000)。相关性分析显示,正常妊娠组和不良妊娠组的tTG和CYPA水平分别呈正相关性(r=0.793,0.812,均P<0.01)。正常妊娠组的tTG和CYPA水平分别与收缩压、24h尿蛋白水平、RI及PI呈正相关性(rtTG=0.802,0.816,0.823,0.799,均P<0.01;rCYPA=0.823,0.806,0.813,0.805,均P<0.01)。不良妊娠组的tTG和CYPA水平分别与收缩压、24h尿蛋白水平、RI及PI呈正相关性(rtTG=0.815,0.827,0.833,0.807,P均<0.01;rCYPA=0.831,0.812,0.824,0.817,均P<0.01)。结论tTG和CYPA可能参与PE的发病机制。高水平的tTG和CYPA可能诱导妊娠高血压和蛋白尿的发生,进而增加PE孕妇发生不良妊娠的风险。

Objective To investigate the correlation between serum levels of cyclophilin A(CYPA)and tissue transglutaminase(tTG)in pregnant women and adverse pregnancy in preeclampsia(PE).Methods 112 pregnant women with PE who were treated in the First People’s Hospital of Xianyang City and the First Hospital of Xi’an City from January 2018 to January 2020 were randomly selected.According to the pregnancy outcome,they were divided into normal pregnancy group(85 cases)and adverse pregnancy group(27 cases).Another 51 healthy pregnant women were selected as control group.Serum CYPA and tTG levels were measured by enzyme-linked immunosorbent assay(ELISA).24h urinary protein level was detected by immunoturbidimetric method.Blood flow resistance parameters of uterine artery were obtained by color Doppler ultrasound,including pulsatility index(PI)and resistance index(RI).The blood pressure and other clinical data of all pregnant women were collected.The correlation between the changes of above indexes and adverse pregnancy in PE pregnant women was compared and analyzed.Results The serum levels of CYPA and tTG in control group,normal pregnancy group and adverse pregnancy group were 59.16±9.71,79.50±13.91,96.18±17.25 ng/L and 7.21±1.13,10.68±1.67,13.35±2.35ng/ml,respectively.Compared with the control group,the levels of serum tTG and CYPA in normal pregnancy group and adverse pregnancy group were significantly increased,especially in adverse pregnancy group,the differences were statistically significant(F=59.286~100.061,P=0.000).Correlation analysis showed that there was a positive correlation between the levels of tTG and CYPA in normal pregnancy group and adverse pregnancy group(r=0.793,0.812,all P<0.01).The levels of tTG and CyPA in normal pregnancy group were positively correlated with systolic blood pressure,24h urinary protein,RI and PI.(rtTG=0.802,0.816,0.823,0.799,all P<0.01;rCyPA=0.823,0.806,0.813,0.805,all P<0.01).The levels of tTG and CyPA in adverse pregnancy group were positively correlated with systolic blood pressure,24h urinary protein,RI and PI(rtTG=0.815,0.827,0.833,0.807,all P<0.01;rCYPA=0.831,0.812,0.824,0.817,all P<0.01).Conclusion tTG and CyPA may be involved in the pathogenesis of PE.High levels of tTG and CYPA may induce pregnancy induced hypertension and proteinuria,and increase the risk of adverse pregnancy in PE pregnant women.