子痫前期患者血浆载脂蛋白C-3表达水平及临床意义

Expression level and clinical significance of plasma ApoC-3 in patients with preeclampsia

目的 分析子痫前期(PE)患者血浆载脂蛋白C-3(ApoC-3)表达水平及临床意义。方法 将2017年1月至2020年12月在荆州市第三人民医院接受常规产检并分娩的104例PE患者分为轻度子痫前期组(mPE组,54例)、重度子痫前期组(sPE组,50例),另将同期年龄和孕周匹配的30例健康孕妇作为对照组。比较3组血浆ApoC-3及其他血生化指标水平。采用多因素线性回归分析ApoC-3等指标对PE患者病情的影响,采用受试者工作特征(ROC)曲线分析ApoC-3水平对PE发生和发展的预测价值。结果 sPE组、mPE组血浆ApoC-3水平显著高于对照组,sPE组血浆ApoC-3水平显著高于mPE组,差异均有统计学意义(P<0.001);3组血肌酐(SCr)、丙氨酸氨基转移酶(ALT)、C反应蛋白(CRP)、血小板计数(PLT)、凝血酶时间(TT)、活化的部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、D-二聚体(D-D)比较,差异均有统计学意义(P<0.05)。多因素线性回归分析显示,ApoC-3与Scr、CRP、PLT、PT、Fib、D-D均是PE患者病情的影响因素(P<0.05);ApoC-3预测PE发生和发展的曲线下面积(AUC)分别为0.981、0.784。结论 PE患者血浆ApoC-3水平较高,其水平与PE患者病情严重程度密切相关,可作为PE发生、发展的预测指标。

Objective To analyze expression level and clinical significance of plasma apolipoprotein C-3(ApoC-3)in patients with preeclampsia(PE).Methods A total of 104 PE patients who received routine prenatal examination and delivered in Jingzhou Third People′s Hospital from January 2017 to December 2020 were divided into mild preeclampsia group(mPE group,54 cases)and severe preeclampsia group(sPE group,50 cases).Meanwhile,30 healthy pregnant women were selected as the control group.Plasma ApoC-3 level and other blood biochemical indexes were compared among the three groups.Multivariate linear regression was used to analyze the influence of ApoC-3 and other indicators on the disease of PE patients,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of ApoC-3 level on the occurrence and development of PE.Results Plasma ApoC-3 levels in sPE group and mPE group were significantly higher than those in the control group,and plasma ApoC-3 level in sPE group was significantly higher than that in mPE group(P<0.001).There were statistically significant differences among the three groups in serum creatinine(SCr),alanine aminotransferase(ALT),C-reactive protein(CRP),platelet count(PLT),thrombin time(TT),activated partial thromboplastin time(APTT),fibrinogen(Fib)and D-dimer(D-D)(P<0.05).Multivariate linear regression analysis showed that ApoC-3,Scr,CRP,PLT,PT,Fib and D-D were all factors affecting the disease condition of patients with PE(P<0.05).The area under the curve(AUC)of ApoC-3 for predicting the occurrence and development of PE were 0.981 and 0.784 respectively.Conclusion The level of plasma ApoC-3 in patients with PE is high,and it is closely related to the severity of PE,which can be used as a prediction index for the occurrence and development of PE.