妊娠期高血压患者血清MMP-9、SDC-1水平对子痫前期发生的预测价值

Predictive value of serum MMP-9 and SDC-1 levels in patients with pregnancy induced hypertension for the occurrence of preeclampsia

目的分析妊娠期高血压(PIH)患者血清基质金属蛋白酶-9(MMP-9)、多配体蛋白聚糖-1(SDC-1)水平对子痫前期发生的预测价值。方法选择2021年1月至2022年5月上海交通大学医学院苏州九龙医院产科收治的PIH患者120例作为PIH组,根据是否发展为子痫前期分为子痫前期组(80例)和非子痫前期组(40例)。另以同期正常妊娠的孕妇110例作为对照组。收集就诊时PIH患者临床信息、血脂和肾功能指标;检测所有孕妇血清MMP-9、SDC-1水平;分析PIH患者血清MMP-9、SDC-1水平与血脂、肾功能指标的相关性,影响PIH患者子痫前期发生的相关因素,血清MMP-9、SDC-1水平对PIH患者子痫前期发生的预测价值。结果PIH组血清MMP-9、SDC-1水平均低于对照组(P<0.05);子痫前期组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、尿酸、24 h尿蛋白定量均高于非子痫前期组(P<0.05),血清MMP-9、SDC-1水平均低于非子痫前期组(P<0.05);PIH患者血清MMP-9与SDC-1水平呈正相关(P<0.05),血清MMP-9、SDC-1水平与TC、TG、LDL-C、尿酸、24 h尿蛋白定量均呈负相关(P<0.05);LDL-C、尿酸、24 h尿蛋白定量是影响PIH患者子痫前期发生的危险因素(P<0.05),血清MMP-9、SDC-1是影响PIH患者子痫前期发生的保护因素(P<0.05);PIH患者血清MMP-9、SDC-1单独预测子痫前期发生的曲线下面积(AUC)分别为0.805、0.723,血清MMP-9、SDC-1二者联合预测子痫前期发生的AUC为0.922,二者联合的AUC高于血清MMP-9、SDC-1单独预测(P<0.05)。结论PIH患者血清MMP-9、SDC-1呈低表达,二者是影响子痫前期发生的保护因素,对子痫前期的发生具有预测价值。

Objective To analyze the predictive value of serummatrix metalloproteinase-9(MMP-9)and syndecan-1(SDC-1)levels in patients with pregnancy induced hypertension(PIH)on the occurrence of preeclampsia.Methods A total of 120 patients with PIH admitted to the Department of Obstetrics,Suzhou Jiulong Hospital,Shanghai Jiao Tong University School of Medicine from January 2021 to May 2022 were enrolled in the PIH group.According to whether they developed preeclampsia,they were divided into the preeclampsia group(80 cases)and the non-preeclampsia group(40 cases).A total of 110 normal pregnant women were selected as the control group.The clinical information,blood lipid and renal function indexes of PIH patients were collected,and the serum levels of MMP-9 and SDC-1 in all pregnant women were detected.The correlation of serum MMP-9 and SDC-1 levels with blood lipid and renal function indexes in PIH patients,the related factors affecting the occurrence of preeclampsia in PIH patients were analyzed,as well as the predictive value of serum MMP-9 and SDC-1 levels on the occurrence of preeclampsia in PIH patients.Results The serum levels of MMP-9 and SDC-1 in PIH group were lower than those in control group(P<0.05).The total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),uric acid and 24 h urine protein quantification in the preeclampsia group were higher than those in the non-preeclampsia group(P<0.05),and the serum MMP-9 and SDC-1 levels were lower than those in the non-preeclampsia group(P<0.05).In PIH patients,serum MMP-9 was positively correlated with SDC-1 level(P<0.05),and serum MMP-9,SDC-1 levels were negatively correlated with TC,TG,LDL-C,uric acid,24 h urine protein quantification(P<0.05).LDL-C,uric acid and 24 h urine protein quantification were risk factors for preeclampsia in patients with PIH(P<0.05),and serum MMP-9 and SDC-1 were protective factors for preeclampsia in patients with PIH(P<0.05).The area under curve(AUC)of serum MMP-9 and SDC-1 alone predicting the occurrence of preeclampsia in PIH patients was 0.805 and 0.723,respectively,the AUC of serum MMP-9 and SDC-1 combined predicting the occurrence of preeclampsia was 0.922,and the AUC of combined detection of the two was higher than that predicted by serum MMP-9 and SDC-1 alone(P<0.05).Conclusion MMP-9 and SDC-1 in serum of PIH patients are lowly expressed,which are protective factors affecting the occurrence of preeclampsia and have predictive value for the occurrence of preeclampsia.