血清Fibulin-3与Ang2水平预测重度子痫前期患者胎盘早剥价值

Predictive value of serum extracellular matrix protein-3 and angiopoietin-2 expression levels for placental abruption of pregnant women with severe preeclampsia

目的:探讨血清细胞外基质蛋白-3(Fibulin-3)与血管生成素-2(Ang2)表达水平对重度子痫前期患者胎盘早剥的预测价值。方法:选取2019年1月-2019年12月本院妇产科收治的重度子痫前期患者380例为病例组,根据患者是否发生胎盘早剥分为早剥组(50例)和非早剥组(330例),产前检查健康孕妇200例为对照组。检测并比较各组血清Fibulin-3、Ang2水平。采用受试者工作特征曲线(ROC)分析血清Fibulin-3、Ang2对重度子痫前期患者发生胎盘早剥的诊断价值,多因素logistic回归法分析影响重度子痫前期患者发生胎盘早剥的相关因素。结果:病例组血清Fibulin-3(33.25±7.52 ng/ml)、Ang2(6.22±1.42 ng/ml)均低于对照组(98.62±10.47 ng/ml、17.22±5.20 ng/ml),且早剥组低于非早剥组(均P<0.05)。ROC曲线分析显示,Fibulin-3诊断重度子痫前期患者发生胎盘早剥的曲线下面积为0.769,截断值为25.35ng/L,敏感度82.6%、特异度75.8%;Ang2诊断重度子痫前期患者发生胎盘早剥的曲线下面积为0.785,截断值5.52ng/L,敏感度85.4%、特异度78.0%。多因素分析显示,收缩压升高、舒张压升高、白蛋白升高、血清Fibulin-3及Ang2降低均是影响重度子痫前期发生及发生胎盘早剥的危险因素(P<0.05)。结论:重度子痫前期患者血清Fibulin-3、Ang2水平异常低表达,且胎盘早剥者水平更低,二者有望作为早期诊断重度子痫前期患者发生胎盘早剥的有效血清学指标。

Objective: To investigate the predictive value of serum extracellular matrix protein-3(Fibulin-3) and angiopoietin-2(Ang2) expression levels for placental abruption of pregnant women with severe preeclampsia. Methods: A total of 380 pregnant women with severe preeclampsia were selected in research group and were divided into group A(50 cases with placental abruption) and the group B(330 cases without placental abruption) according to occurrence of placental abruption from January 2019 to December 2019. 200 healthy pregnant women who came to hospital for antenatal examination were selected in control group during the same period. The expression levels of serum Fibulin-3 and Ang2 of the women were compared between the two groups. Receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of the serum Fibulin-3 and Ang2 levels of the women for their placental abruption. Multivariate logistic regression method was used to analyze the related factors of placental abruption of the women with severe preeclampsia. Results: The levels of serum Fibulin-3(33.25±7.52 ng/ml) and Ang2(6.22±1.42 ng/ml) of the women in the research group were significantly lower than those(98.62±10.47 ng/ml and 17.22±5.20 ng/ml) of the women in the control group,and which of the women in group A were significantly lower than those of the women in group B(P<0.05).ROC curve analysis showed that the area under the curve,the cut-off value,the sensitivity,and the specificity of the Fibulin-3level of the women with severe preeclampsia for diagnosing their placental abruption were 0.769,25.35ng/L,82.6%,and 75.8%,respectively.The area under the curve,the cut-off value,the sensitivity,and the specificity of the Ang2level of the women with severe preeclampsia for diagnosing their placental abruption were 0.785,5.52ng/L,85.4%,and 78.0%,respectively.Multivariate analysis showed that the abnormal systolic blood pressure,diastolic blood pressure,albumin,serum Fibulin-3and Ang2levels of the women were the risk factors of their severe preeclampsia and placental abruption(P<0.05).Conclusion:The serum levels of Fibulin-3and Ang2of the pregnant women with severe preeclampsia are low abnormally,and which of the women with placental abruption are lower,and both of which are expected to be the effective indicators for early diagnosing the placental abruption of these women.