子痫前期患者血清CTRP6、sTNFR-Ⅱ水平及其诊断价值

Levels of serum Clq/tumor necrosis factor related protein 6 and soluble tumor necrosis factor receptor of pregnant women with preeclampsia and their diagnostic values for preeclampsia

目的:探究子痫前期(PE)患者血清C1q/肿瘤坏死因子相关蛋白6(CTRP6)、可溶性肿瘤坏死因子受体(sTNFR)-Ⅱ水平及其诊断价值。方法:选取2021年6月-2022年6月在本院确诊为PE的患者148例临床资料为PE组,根据病情程度分为轻度PE组(85例)和重度PE组(63例),常规产前检查健康孕妇75例为对照组。酶联免疫吸附测定法测定各组血清CTRP6、sTNFR-Ⅱ水平;Pearson法分析PE患者血清CTRP6、sTNFR-Ⅱ的相关性;受试者工作特征曲线(ROC)分析CTRP6、sTNFR-Ⅱ对PE发生发展的诊断价值。结果:重度PE组、轻度PE组、对照组尿蛋白定量、ALT、Fib、Cr、收缩压、舒张压水平依次降低,PT值依次增加,血清CTRP6、sTNFR-Ⅱ水平依次降低(均P<0.05)。相关性分析,PE患者血清CTRP6与sTNFR-Ⅱ的表达呈正相关(r=0.354,P<0.001)。ROC曲线分析,CTRP6与sTNFR-Ⅱ联合诊断PE发生的曲线下面积(AUC)(0.975)高于CTRP6、sTNFR-Ⅱ单独诊断,其敏感度、特异性分别为79.7%和92.3%;诊断重度PE的AUC为0.925,敏感度、特异性分别为39.7%和98.8%,高于CTRP6和sTNFR-Ⅱ单独诊断(均P<0.001)。结论:PE患者血清CTRP6、sTNFR-Ⅱ水平异常升高,二者与疾病严重程度有关,且联合诊断可提高PE的诊断效能。

Objective:To investigate the levels of serum C1q/tumor necrosis factor related protein 6(CTRP6)and solu-ble tumor necrosis factor receptor(sTNFR)-Ⅱ of pregnant women with preeclampsia(PE),and to study their diagnostic values for PE.Methods:The clinical data of 148 pregnant women with confirmed PE(in group A)from June 2021 to June 2022 were selected.These women were divided group A1(85 cases with mild PE)and group A2(63 cases with severe PE)according to the severity of PE.75 healthy pregnant women were selected in group B during the same period.The expression levels of serum CTRP6 and sTNFR-Ⅱ of the women in these groups were determined by enzyme-linked immunosorbent assay(ELISA).Pearson method was used to analyze the correlation between the serum CTRP6 level of the women with PE and the level of their sTNFR-Ⅱ.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of CTRP6 and sTNFR-Ⅱ for the occurrence and development of PE.Results:The levels of urinary protein quantity,ALT,Fib,and Cr,the values of systolic and diastolic blood pressure,and the serum CTRP6 and sTNFR-Ⅱ levels of the women in group A2,group A1,and group B had decreased gradually,and the PT value of the women in group A2,group A1,and group B had increased gradually(all P<0.05).Correlation analysis showed that the serum CTRP6 level of the women with PE was positively correlated with their sTNFR-Ⅱ level(r=0.354,P<0.001).ROC curve analysis showed that the area under the curve(AUC)of the CTRP6 level combined with the sTNFR-Ⅱ level of the women for diagnosing their PE(0.975)was significantly higher than that of the CTRP6 level and the sTNFR-Ⅱ level alone,and the sensitivity and the speificity of which were 79.7%and 92.3%.The AUC,the sensitivity,and the specificity of the CTRP6 level combined with the sTNFR-Ⅱ level for diagnosing severe PE was 0.925,39.7%,and 98.8%,respectively,and which were significantly higher than that of the CTRP6 level and the sTNFR-Ⅱ level alone(all P<0.001).Conclusion:The levels of serum CTRP6 and sTNFR-Ⅱ of the pregnant women with PE increase abnormally,both of which are related to the severity of PE,and the diagnostic efficacy of the combined levels of serum CTRP6 and sTNFR-Ⅱ for PE is higher.