摘要
目的探讨妊娠期高血压疾病患者血清Kisspeptin水平及其对患者妊娠结局的预测价值。方法选取2020年6月至2022年6月在洪湖市妇幼保健院产科住院并分娩的85例妊娠期高血压疾病患者为研究对象(观察组),根据病情严重程度分为妊娠期高血压组22例、轻度子痫前期组28例和重度子痫前期组35例,根据妊娠结局的不同分为不良妊娠结局组和正常妊娠结局组;另选取同期在洪湖市妇幼保健院定期产检并分娩的120例正常妊娠者作为对照组。采用酶联免疫吸附试验(ELISA)检测各组血清Kisspeptin水平;采用多因素Logistic回归分析妊娠期高血压疾病发生的影响因素,采用受试者工作特征(ROC)曲线分析血清Kisspeptin水平对妊娠期高血压疾病患者妊娠结局的预测价值。结果观察组孕前体质量指数(BMI)、24 h尿蛋白、收缩压、舒张压、Kisspeptin水平均明显高于对照组(P<0.05)。多因素Logistic回归分析结果显示,24 h尿蛋白水平高、收缩压高、血清Kisspeptin水平升高均是妊娠期高血压疾病发生的危险因素(P<0.05)。妊娠期高血压疾病患者血清Kisspeptin水平表现为妊娠期高血压组<轻度子痫前期组<重度子痫前期组,任意两组间比较,差异均有统计学意义(P<0.05)。观察组不良妊娠结局总发生率为69.41%,明显高于对照组的22.50%,差异有统计学意义(P<0.05)。不良妊娠结局组59例、正常妊娠结局组26例。观察组中不良妊娠结局组血清Kisspeptin水平高于正常妊娠结局组(P<0.05)。血清Kisspeptin预测妊娠期高血压疾病患者发生不良妊娠结局的曲线下面积为0.874(95%CI:0.796~0.951),最佳截断值为78.41 ng/L,灵敏度为84.70%,特异度为88.50%。结论血清Kisspeptin在妊娠期高血压疾病患者中水平升高,是妊娠期高血压疾病发生的危险因素,且对患者发生不良妊娠结局具有较好的预测效能。
Objective To investigate the level of serum Kisspeptin and its predictive value for pregnancy outcome in the patients with pregnancy induced hypertension.Methods A total of 85 patients with pregnancy induced hypertension hospitalized and delivered in the obstetrics and gynecology department of Honghu Municipal Maternal and Child Health Care Hospital from June 2020 to June 2022 were selected as the study subjects(observation group).According to the severity of the disease condition,they were divided into the gestational hypertension group(22 cases),mild preeclampsia group(28 cases)and severe preeclampsia group(35 cases).According to different pregnancy outcomes,they were divided into the adverse pregnancy outcome group and normal pregnancy outcome group;other 120 normal pregnant women undergoing regular prenatal check ups and delivery in this hospital were selected as the control group.The enzyme linked immunosorbent assay(ELISA)was used to detect the serum Kisspeptin level in each group;the multiple Logistic regression was used to analyze the factors affecting the occurrence of pregnancy induced hypertension,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum Kisspeptin level on pregnancy outcomes in the patients with pregnancy induced hypertension.Results The pre-pregnancy body mass index(BMI),24 h urine protein,systolic blood pressure,diastolic blood pressure and Kisspeptin level in the observation group were significantly higher than those in the control group(P<0.05).The results of multivariate Logistic regression analysis showed that the increase of 24 h urine protein,systolic blood pressure and serum Kisspeptin levels all were the risk factors affecting the occurrence of pregnancy induced hypertension(P<0.05).The serum Kisspeptin level in the patients with pregnancy induced hypertension was manifested by the gestational hypertension group<the mild preeclampsia group<the severe preeclampsia group,and the difference between any two groups was statistically significant(P<0.05).The total incidence rate of adverse pregnancy outcomes in the observation group was 69.41%,which was significantly higher than 22.50%in the control group with statistically significant difference(P<0.05).In the observation group,there were 59 cases of adverse pregnancy outcomes and 26 cases of normal pregnancy outcomes.In the observation group,the serum Kisspeptin level in the adverse pregnancy outcomes group was higher than that in the normal pregnancy outcomes group(P<0.05).The area under the curve(AUC)of serum Kisspeptin for predicting the adverse pregnancy outcomes in the patients with pregnancy induced hypertension was 0.874(95%CI:0.796-0.951),with an optimal cut-off value of 78.41 ng/L,the sensitivity of 84.70%and specificity of 88.50%.Conclusion Serum Kisspeptin level in the patients with pregnancy induced hypertension is increased,which is a risk factor for the occurrence of pregnancy induced hypertension,moreover has good predictive efficiency for adverse pregnancy outcomes.
作者
黄俊
陈利
刘琴霞
汪晶
HUANG Jun;CHEN Li;LIU Qinxia;WANG Jing(Department of Obstetrics,Honghu Municipal Maternal and Child Health Care Hospital,Honghu,Hubei 433200,China;Department of Gynecology,People′s Hospital of Wuhan University,Wuhan,Hubei 430060,China)
出处
《检验医学与临床》
CAS
2024年第12期1671-1675,共5页
Laboratory Medicine and Clinic
基金
湖北省自然科学基金资助项目(WJ2019A265)。