妊娠期高血压患者血清转化生长因子-β1和Smad3、Smad4浓度与临床意义

Serum Concentrations of Transforming Growth Factor-β1,Smad3,Smad4 and Their Clinical Significance in Patients with Hypertension During Pregnancy

目的探讨妊娠期高血压(hypertension during pregnancy,HDP)患者血清转化生长因子-β1(transforming growth factor-β1,TGF-β1)和Smad3、Smad4的浓度与临床意义。方法选取河北中石油中心医院妇产科2021年1月至2022年8月诊治的96例HDP患者作为研究组,同时选取96名在本院产检且一般资料与HDP患者相匹配的正常孕妇作为对照组。采用Logistic回归分析影响孕妇发生HDP的相关因素;采用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析TGF-β1和Smad3、Smad4对HDP的诊断效能。结果两组患者年龄、孕周、孕次、三酰甘油(triacylglycerol,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(lowdensity lipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)比较,差异均无统计学意义(P>0.05)。研究组患者血清TGF-β1、Smad3、Smad4浓度及有原发性高血压(高血压)家族史的患者所占比例均显著高于对照组,差异有统计学意义(P<0.05)。有高血压家族史、TGF-β1、Smad3、Smad4浓度升高均为孕妇发生HDP的危险因素(P<0.05)。血清TGF-β1、Smad3、Smad4诊断HDP的曲线下面积(AUC)分别为0.652、0.720、0.730,而三者联合诊断的曲线下面积为0.916,三者联合优于血清TGF-β1、Smad3、Smad4各自单独诊断(Z三者联合-TGF-β1=6.864、Z三者联合-Smad3=5.955、Z三者联合-Smad4=5.907,P均<0.001),其敏感度和特异度分别为82.29%、78.50%。结论血清TGF-β1、Smad3、Smad4浓度与HDP的发生密切相关,三者联合检测对HDP具有较高的诊断价值。

Objectives To investigate the clinical significance of serum concentrations of transforming growth factor-β1(TGF-β1),Smad3 and Smad4 in patients with hypertension during pregnancy(HDP).Methods From January 2021 to August 2022,96 patients with HDP diagnosed and treated in Hebei Petro China Central Hospital were regarded as study group,meantime,96 normal pregnant women who were examined in Hebei Petro China Central Hospital and matched with HDP patients were regarded as control group.Logistic regression was applied to analyze the related factors affecting the occurrence of HDP in pregnant women;receiver operating characteristic curve(ROC)was applied to analyze the diagnostic efficacy of TGF-β1,Smad3 and Smad4 in HDP.Results There was no obvious difference in age,gestational week,gestational time,triacylglycerol(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)between the two groups(P>0.05).The serum concentrations of TGF-β1,Smad3,Smad4,and the proportion of patients with family history of hypertension in study group were obviously higher than those in control group(P<0.05).The family history of hypertension and the increased serum concentrations of TGF-β1,Smad3 and Smad4 were risk factors for HDP in pregnant women(P<0.05).The area under the curve(AUC)of serum TGF-β1,Smad3 and Smad4 in diagnosis of HDP was 0.652,0.720 and 0.730 respectively,while the AUC of combined diagnosis of the three was 0.916,the combination of the three was superior to the independent diagnosis of serum TGF-β1,Smad3 and Smad4(Z combination-TGF-β1=6.864,Z combination-Smad3=5.955,Z combination-Smad4=5.907,P<0.001),and its sensitivity and specificity were 82.29%and 78.50%respectively.Conclusions The serum concentrations of TGF-β1,Smad3 and Smad4 are closely related to the occurrence of HDP.The combined detection of TGF-β1,Smad3 and Smad4 has a high diagnostic value for HDP.