血清NEFA、MPV及sFlt-1与妊娠期高血压疾病严重程度及病情进展的相关性分析

Correlation analysis of serum NEFA, MPV and sFlt-1 with the severity and progression of hypertensive diseases during pregnancy

目的分析血清游离脂肪酸(NEFA)、平均血小板体积(MPV)及可溶性Fms样酪氨酸激酶-1(sFlt-1)与妊娠期高血压疾病严重程度及病情进展的相关性。方法回顾性选择2020年1月至2022年1月亳州市人民医院门诊收治的156例妊娠期高血压疾病孕妇为观察组,其中妊娠期高血压118例、子痫前期38例;另选156名孕检结果正常的孕妇作为对照组。检测所有孕妇血清NEFA、MPV及sFlt-1表达水平,分析妊娠期高血压疾病孕妇血清NEFA、MPV及sFlt-1表达水平与24 h尿蛋白定量(24 h UPQ)、血液黏度(BV)、红细胞压积(HCT)和血小板计数(PLT)的关系,观察妊娠期高血压疾病的病情进展情况,通过使用受试者工作特征曲线(ROC)下面积(AUC)评价血清NEFA、MPV联合sFlt-1对妊娠期高血压疾病进展的预测效能。结果观察组血清NEFA、MPV及sFlt-1表达水平为(0.68±0.34)mmol/L、(11.05±1.13)fL、(8.73±1.87)ng/mL,均高于对照组[(0.45±0.13)mmol/L、(9.89±0.72)fL、(2.64±0.46)ng/mL],差异均有统计学意义(P<0.05)。子痫前期组血清NEFA、MPV、sFlt-1、24 h UPQ、BV、HCT水平为(0.79±0.46)mmol/L、(13.05±1.62)fL、(10.05±2.63)ng/mL、(6.49±1.35)g、(4.91±0.63)mPa·s、(0.42±0.11),均高于妊娠期高血压组[(0.61±0.30)mmol/L、(10.71±0.94)fL、(5.16±1.27)ng/mL、(5.08±1.01)g、(4.58±0.42)mPa·s、(0.31±0.06)],PLT为(9.56±1.52)×10^(9)/L,小于妊娠期高血压组[(10.72±2.18)×109/L],差异均有统计学意义(P<0.05)。经Pearson相关性分析,妊娠期高血压疾病孕妇血清NEFA、MPV及sFlt-1表达水平与24 h UPQ、BV、HCT均呈正相关,与PLT均呈负相关(P<0.05)。在156例妊娠期高血压疾病孕妇中,病情进展28例,占17.95%;经ROC曲线分析,血清NEFA、MPV联合sFlt-1预测妊娠期高血压疾病进展的AUC为0.910。结论血清NEFA、MPV及sFlt-1与妊娠期高血压疾病严重程度密切相关,联合预测病情进展的效能较好,值得临床予以重视应用。

Objective To analyze the correlation between serum free fatty acid(NEFA),mean platelet volume(MPV)and soluble Fms like tyrosine kinase-1(sFlt-1)and the severity and progression of hypertensive diseases during pregnancy.Methods A total of 156 pregnant women with pregnancy-induced hypertension admitted to The People's Hospital of Bozhou from January 2020 to January 2022 were retrospectively selected as the observation group,including pregnancy-induced 118 cases of pregnancy hypertension and 38 cases of preeclampsia.One hundred and fifty-six pregnant women with normal pregnancy test results were selected as control group.The expression levels of NEFA,MPV and sFlt-1 in serum of all pregnant women were detected,and the relationship between the expression levels of NEFA,MPV and sFlt-1 in serum and 24 h urinary protein quantification(24 h UPQ),blood viscosity(BV),hematopoiasis(HCT)and platelet count(PLT)in pregnant women with hypertensive diseases during pregnancy was analyzed.To observe the progression of hypertensive diseases during pregnancy,the area under receiver operating characteristic curve(ROC)(AUC)was used to evaluate the predictive efficacy of serum NEFA and MPV combined with sFlt-1 on the progression of hypertensive diseases during pregnancy.Results The expression levels of NEFA,MPV and sFlt-1 in serum in observation group were(0.68±0.34)mmol/L,(11.05±1.13)fL,(8.73±1.87)ng/mL,which were higher than those in control group[(0.45±0.13)mmol/L,(9.89±0.72)fL,(2.64±0.46)ng/mL],the differences were statistically significant(P<0.05).The expression levels of NEFA,MPV,sFlt-1,24h UPQ,BV and HCT and in preeclampsia group were(0.79±0.46)mmol/L,(13.05±1.62)fL,(10.05±2.63)ng/mL,(6.49±1.35)g,(4.91±0.63)mPa·s,(0.42±0.11),which were higher than those in gestational hypertension group[(0.61±0.30)mmol/L,(10.71±0.94)fL,(5.16±1.27)ng/mL,(5.08±1.01)g,(4.58±0.42)mPa·s,(0.3±0.06)],PLT was(9.56±1.52)×10^(9)/L,which was smaller than that in hypertensive pregnancy group[(10.72±2.18)×109/L],the differences were statistically significant(P<0.05).According to Pearson correlation analysis,the serum expression levels of NEFA,MPV and sFlt-1 in pregnant women with hypertensive diseases during pregnancy were positively correlated with 24 h UPQ,BV and HCT,and negatively correlated with PLT(P<0.05).Among 156 pregnant women with hypertensive diseases during pregnancy,28 cases(17.95%)progressed.According to ROC curve analysis,the AUC of serum NEFA and MPV combined with sFlt-1 to predict the progression of hypertension during pregnancy was 0.910.Conclusion Serum NEFA,MPV and sFlt-1 are closely related to the severity of hypertensive diseases during pregnancy.The combination of NEFA,MPV and sFlt-1 is effective in predicting the progression of hypertensive diseases.