孕晚期血管内皮损伤标志物对ABO型胎儿新生儿溶血病的产前诊断预测意义

Significance of markers of vascular endothelial injury in late pregnancy for prenatal diagnosis and prediction of ABO-haemolytic disease of the fetus and newborn

目的 探讨孕晚期血管内皮损伤标志物对ABO型胎儿新生儿溶血病(HDFN)的预测意义,为产前诊断和早期防治提供理论依据。方法 选取2020年4—12月于本院产检的74名O型Rh(D)阳性孕妇,且孕妇与丈夫血型不同。检测孕妇孕晚期血管内皮损伤标志物[血管内皮钙黏蛋白(VE-Cad)、P-选择素(P-Selectin)、血管内皮细胞黏附分子-1(VCAM-1)],并随访孕妇至产后。记录新生儿发生ABO HDFN情况,并依据新生儿是否发生ABO-HDFN,将孕妇分为ABO-HDFN组(n=39)与对照组(n=35),并分析孕妇上述检测指标与ABO-HDFN的相关性。结果 ABO-HDFN组与对照组孕妇年龄、分娩方式、新生儿性别比较差异无统计学意义,而ABO-HDFN组孕妇的VE-Cad、P-Selectin、VCAM-1水平均高于对照组,差异有统计学意义(P<0.05)。结论 孕晚期测定血管内皮损伤标志物对防治ABO型HDFN具有重要预测意义。

Objective To explore the predictive significance of markers of vascular endothelial injury in late pregnancy in ABO-hemolytic disease of fetuses and neonates(HDFN), and to provide theoretical basis for prenatal diagnosis and early prevention and treatment. Methods 74 cases of O type Rh(D) positivepregnant women were collected in our hospital from April to December 2020, and their blood types were different from their husbands’. The markers of vascular endothelial injury(vascular endothelial cadherin [VE-Cad], P-selectin, vascular endothelial cell adhesion molecule-1 [VCAM-1]) were detected in pregnant women in the third trimester and followed up to postpartum. ABO-HDFN was recorded, and the pregnant women were divided into ABO-HDFN group(n=39) and control group(n=35) according to whether ABO-HDFN occurred in newborns,and the correlation between the above detection indexes and ABO-HDFN in pregnant women was analyzed. Results There were no statistically significant differences in the age, mode of delivery and sex of newborn between ABO-HDFN group and control group, but the levels of VE-Cad, P-selectin and VCAM-1 in ABO-HDFN group were higher than those in control group(P<0.05). Conclusion The determination of vascular endothelial injury markers in late pregnancy has important predictive significance for the prevention and treatment of ABO-HDFN.