血清胎盘生长因子、血管生成素-2联合应激诱导蛋白2预测重度子痫前期患者胎盘早剥的临床研究

Clinical Study of Serum Placental Growth Factor,Angiopoietin-2 Combined with Stress Induced Protein 2 in Predicting Placental Abruption in Patients with Severe Preeclampsia

目的:探讨重度子痫前期(SPE)患者胎盘早剥的危影响因素,并探讨胎盘生长因子(PLGF)、血管生成素-2(Ang2)联合应激诱导蛋白2(Sestrin2)对重度子痫前期并发胎盘早剥的预测价值。方法:选取2019年4月至2022年4月长沙市第四医院收治的SPE患者348例。根据患者是否发生胎盘早剥分组,分为胎盘早剥组(n=75)和无胎盘早剥组(n=273)。检测并对比两组血清PLGF、Ang2及Sestrin2水平。采用单因素及多因素Logistic回归模型分析SPE患者并发胎盘早剥的影响因素;采用受试者工作特征(ROC)曲线分析PLGF、Ang2联合Sestrin2对SPE患者并发胎盘早剥的预测价值。结果:胎盘早剥组的PLGF、Ang2低于无胎盘早剥组,Sestrin2高于无胎盘早剥组(P<0.05)。SPE并发胎盘早剥与剖宫产史、收缩压(SBP)、舒张压(DBP)、血小板、尿素氮、纤维蛋白原、血肌酐有关(P<0.05)。多因素Logistic回归模型分析结果显示:SBP偏高、DBP偏高、纤维蛋白原偏低、血肌酐偏高是SPE并发胎盘早剥的危险因素。Sestrin2水平下降,PLGF、Ang2水平升高则是SPE并发胎盘早剥的保护因素(P<0.05)。血清PLGF、Ang2联合Sestrin2检测对SPE并发胎盘早剥的预测价值优于各指标单独检测(P<0.05)。结论:SPE并发胎盘早剥患者中Sestrin2水平升高,PLGF、Ang2水平下降,联合检测可以辅助预测SPE并发胎盘早剥的发生。SBP偏高、DBP偏高、纤维蛋白原偏低、血肌酐偏高是SPE并发胎盘早剥的危险因素。Sestrin2水平下降,PLGF、Ang2水平升高是SPE患者并发胎盘早剥的保护因素。

Objective:To investigate the risk factors of placental abruption in patients with severe preeclampsia(SPE),and explore the predictive value of placental growth factor(PLGF),angiopoietin-2(Ang2)combined with stress induced protein 2(Sestrin2)in severe preeclampsia complicate with placental abruption.Methods:348 SPE patients who were admitted to the Fourth Hospital of Changsha from April 2019 to April 2022 were selected.Patients were grouped according to whether placental abruption occurred,patients were divided into placental abruption group(n=75)and no placental abruption group(n=273).The serum levels of PLGF,Ang2 and Sestrin2 were detected and compared between two groups.The influencing factors in SPE patients with placental abruption were analyzed by univariate and multivariate Logistic regression models;The predictive value of PLGF,Ang2 combined with Sestrin2 in SPE patients with placental abruption were analyzed by receiver operating characteristic(ROC)curve.Results:PLGF and Ang2 in placental abruption group were lower than those in no placental abruption group,Sestrin2 was higher than that in no placental abruption group(P<0.05).SPE complicated with placental abruption was related to the history of cesarean section,systolic blood pressure(SBP),diastolic blood pressure(DBP),platelet,urea nitrogen,fibrinogen and serum creatinine(P<0.05).Multivariate Logistic regression model analysis showed that:high SBP,high DBP,low fibrinogen and high serum creatinine were risk factors for SPE complicated with placental abruption.Sestrin2 level decreased,the increase of PLGF and Ang2 levels was a protective factor for SPE complicated with placental abruption(P<0.05).The predictive value of serum PLGF,Ang2 combined with Sestrin2 for SPE complicated with placental abruption was better than that of each index alone(P<0.05).Conclusion:The level of Sestrin2 increas in SPE patients with placental abruption,the levels of PLGF and Ang2 decreas,and combine detection can assist in predicting the occurrence of SPE complicate with placental abruption.High SBP,high DBP,low fibrinogen and high serum creatinine are risk factors for SPE complicate with placental abruption.Sestrin2 level decrease,and the increase of PLGF and Ang2 levels is a protective factor for SPE patients with placental abruption.