血清IL-18和IL-33联合PTX-3对子痫前期孕妇妊娠结局的预测价值

Predictive value of serum IL⁃18,IL⁃33 combined with PTX⁃3 on pregnancy outcomes in preeclampsia pregnant women

目的分析血清白介素-18(IL-18)、IL-33联合正五聚蛋白-3(PTX-3)水平,探究其在子痫前期孕妇妊娠结局的预测价值。方法选取2021年2月-2023年4月于沧州市人民医院就诊的子痫前期孕妇110例为子痫组,同时选取同期产检正常的60名孕妇作为正常组。比较正常组与子痫组血清IL-18、IL-33、PTX-3水平以及不良妊娠结局;子痫组根据妊娠结局分为良好妊娠组(n=71)与不良妊娠组(n=39),比较两组临床资料和IL-18、IL-33、PTX-3水平,分析影响子痫前期孕妇妊娠结局的因素及其对不良妊娠结局的预测价值。结果子痫组IL-18(49.83±5.08)ng/L、PTX-3(2.77±0.31)μg/L水平高于正常组(45.08±4.55)ng/L、(1.31±0.15)μg/L,IL-33(21.44±2.46)ng/L低于正常组(29.69±3.13)ng/L,差异均有统计学意义(t=6.040、34.322、18.939,P均<0.05)。子痫组发生不良妊娠结局的发病率为35.45%,高于正常组8.33%,差异有统计学意义(χ^(2)=14.886,P<0.05)。不良妊娠组与良好妊娠组的年龄、入组孕周、收缩压、舒张压、24 h尿蛋白定量、血尿素氮、血肌酐、IL-18、IL-33、PTX-3差异均有统计学意义(P均<0.05)。Logistic回归分析显示,IL-18、IL-33、PTX-3水平是子痫组妊娠结局的影响因素(P<0.05)。IL-18、IL-33、PTX预测子痫前期孕妇不良妊娠结局的AUC分别为0.765、0.766、0.764,三者联合预测AUC(0.922)大于各自单独预测(Z_(联合vs.IL-18)=2.901,P=0.004;Z_(联合vs.IL-33)=3.092,P=0.002;Z_(联合vs.PTX-3)=2.655,P=0.008)。结论子痫前期孕妇血清IL-18、IL-33、PTX-3表达异常,血清IL-18、IL-33、PTX-3水平与子痫前期孕妇的不良妊娠结局相关,均有一定预测不良妊娠结局的价值,联合检测的预测价值更高。

Objective To analyze the predictive value of serum interleukin⁃18(IL⁃18),IL⁃33 combined with pentraxin⁃3(PTX⁃3)on pregnancy outcomes in preeclampsia pregnant women.Methods From February 2021 to April 2023,110 pregnant women with preeclampsia who visited Cangzhou People's Hospital were collected and included in the preeclampsia group.Meantime,60 pregnant women who had normal prenatal examinations from February 2021 to April 2023 were regarded as the normal group.The serum levels of IL⁃18,IL⁃33,PTX⁃3,and adverse pregnancy outcomes were compared between the normal group and the eclampsia group;the preeclampsia group was separated into a good pregnancy group(n=71)and an adverse pregnancy group(n=39)based on pregnancy outcomes;the data and the levels of IL⁃18,IL⁃33,and PTX⁃3 were compared;the factors affecting the pregnancy outcomes of preeclampsia pregnant women and their predictive value for adverse pregnancy outcomes were analyzed.Results The levels of IL⁃18(49.83±5.08)ng/L and PTX⁃3(2.77±0.31)μg/L in the preeclampsia group were higher than those in the normal group(45.08±4.55)ng/L,(1.31±0.15)μg/L,while IL⁃33 level(21.44±2.46)ng/L was lower than that in the normal group(29.69±3.13)ng/L,the differences were statistically significant(t=6.040,34.322,18.939;all P<0.05).There were 39 cases with adverse pregnancy outcomes in the eclampsia group,with an incidence rate of 35.45%,which was higher than the incidence rate of 8.33%in the normal group,the differences was statistically significant(P<0.05).Poor pregnancy group was different from good pregnancy group in age,gestational age,systolic and diastolic blood pressure,24⁃hour urine protein quantification,blood urea nitrogen,blood creatinine,IL⁃18,IL⁃33,and PTX⁃3(P<0.05).Logistic regression analysis showed that IL⁃18,IL⁃33,and PTX⁃3 were the influencing factors of pregnancy outcomes in the preeclampsia group(P<0.05).The AUC(0.922)of the combined prediction of IL⁃18,IL⁃33,and PTX⁃3 for adverse pregnancy outcomes in preeclampsia pregnant women was greater than the AUC(0.765,0.766,0.764)predicted by IL⁃18,IL⁃33,and PTX⁃3,respectively(Z_(combined vs.IL⁃18)=2.901,P=0.004;Z_(combined vs.IL⁃33)=3.092,P=0.002;Z_(combined vs.PTX⁃3)=2.655,P=0.008).Conclusion Serum IL⁃18,IL⁃33,and PTX⁃3 levels had certain predictive value for pregnancy outcomes in preeclampsia pregnant women,and the combined detection had higher predictive value.