子痫前期血清中血管生成抑制蛋白1水平与胎儿生长受限的相关性分析

Correlation analysis between serum levels of angiogenic inhibitory protein-1 and fetal growth restriction in preeclampsia

目的检测子痫前期(PE)病人血清中血管生成抑制蛋白1(VASH1)的水平,分析其与胎儿生长受限(FGR)的相关性。方法选取2020年3月至2022年3月雅安市人民医院收治的152例PE病人作为研究对象,其中发生FGR的有80例(FGR组),未发生FGR的有72例(非FGR组)。采用酶联免疫吸附法测定血清VASH1水平;受试者操作特征曲线(ROC曲线)分析血清VASH1水平对PE病人发生FGR的预测价值;logistic回归分析PE病人发生FGR的影响因素。结果FGR组PE病人尿蛋白(186.71±11.15)mg/24 h、收缩压(166.66±10.11)mmHg、舒张压(95.52±7.17)mmHg水平均显著高于非FGR组[(167.62±10.51)mg/24 h、(153.62±9.19)mmHg、(89.80±6.11)mmHg](均P<0.05)。FGR组PE病人血清VASH1水平(467.89±111.24)ng/L显著高于非FGR组(328.33±69.54)ng/L(P<0.05)。FGR组PE病人胎儿胫骨长度(5.93±0.20)cm、双顶径(7.87±0.21)cm、头围(28.15±1.27)cm显著低于非FGR组[(6.59±0.38)cm、(8.64±0.47)cm、(31.43±1.36)cm](均P<0.05)。FGR病人血清中VASH1的水平与尿蛋白、收缩压、舒张压水平呈正相关,与胎儿胫骨长度、双顶径、头围水平呈负相关(均P<0.05)。单因素回归分析表明,高水平VASH1、高水平尿蛋白、高水平舒张压是影响FGR发生的危险因素(P<0.05);多因素分析得知,高水平VASH1、高水平尿蛋白、高水平舒张压是影响FGR发生的独立危险因素(P<0.05)。结论FGR组PE病人血清VASH1水平显著高于非FGR组,是影响PE病人发生FGR的独立危险因素,检测血清VASH1水平有利于筛查出PE病人中FGR发生风险较高的病人。

Objective To measure the level of serum angiogenic inhibitory protein 1(VASH1)in patients with preeclampsia(PE)and analyze its correlation with fetal growth restriction(FGR).Methods A total of 152 PE patients admitted to Ya'an People's Hospital from March 2020 to March 2022 were included in the study;80 of these patients developed FGR(FGR group),and 72 did not develop FGR(non-FGR group).The serum VASH1 concentration was measured by enzyme-linked immunosorbent assay(ELISA);the predictive value of the serum VASH1 concentration for the occurrence of FGR in PE patients was analyzed by receiver operating characteristic(ROC)curve analysis;and the factors influencing the occurrence of FGR in PE patients were analyzed by logistic regression.Results Urinary protein(186.71±11.15)mg/24 h,systolic blood pressure(166.66±10.11)mmHg,and diastolic blood pressure(95.52±7.17)mmHg were significantly greater in PE patients in the FGR group than in those in the non-FGR group[(167.62±10.51)mg/24 h,(153.62±9.19)mmHg,and(89.80±6.11)mmHg,respectively](P<0.05).The serum VASH1 level of PE patients in the FGR group(467.89±111.24)ng/L was significantly greater than that in the non-FGR group(328.33±69.54)ng/L(P<0.05).In the PE patients in the FGR group,fetal tibia length(5.93±0.20)cm,biparietal diameter(7.87±0.21)cm,and head circumference(28.15±1.27)cm were signif-icantly lower than those in the non-FGR group[(6.59±0.38)cm,(8.64±0.47)cm,and(31.43±1.36)cm,respectively](P<0.05).The se-rum VASH1 level in FGR patients was positively correlated with urine protein,systolic blood pressure and diastolic blood pressure and negatively correlated with fetal tibia length,biparietal diameter and head circumference(P<0.05).Univariate regression analysis re-vealed that high VASH1 levels,high urine protein levels,and high diastolic blood pressure were risk factors for affecting the occur-rence of FGR(P<0.05).Multivariate analysis revealed that a high level of VASH1,a high level of urine protein,and a high diastolic blood pressure were independent risk factors for the occurrence of FGR(P<0.05).Conclusion The serum VASH1 level of PE patients in FGR group was obviously greater than that in the non-FGR group,which was an independent risk factor affecting the occurrence of FGR in PE patients and the detection of the serum VASH1 level was conducive to identifying PE patients with a greater risk of FGR.