子痫前期患者孕早期血清中ET-1与PLGF的表达及预后意义

Expression of ET⁃1 and PLGF in serum of preeclampsia patients in early pregnancy and its prognostic significance

目的 探讨子痫前期患者血清中内皮素-1(endothelin-1, ET-1)与胎盘生长因子(placental growth factor, PLGF)的表达及预后意义。方法 回顾性分析2019年3月至2021年5月联勤保障部队第九〇四医院收治的89例子痫前期患者的临床资料(观察组),另选取医院同时间段行常规孕检的81例健康孕妇的临床资料(对照组)。观察组孕早期入院后检测血清ET-1与血清PLGF水平,对照组于孕早期体检当天检测。分析血清ET-1与血清PLGF水平的相关性。随访至妊娠终止,比较2组研究对象预后情况。根据观察组患者的预后情况分为预后良好组与预后不良组,以多因素logistic回归分析子痫前期患者预后不良的危险因素。绘制受试者操作特征(receiver operating characteristic, ROC)曲线,以曲线下面积(area under the curve, AUC)评估血清ET-1与血清PLGF水平对观察组患者预后的预测价值。结果 观察组患者血清ET-1水平高于对照组,血清PLGF水平低于对照组(P<0.05)。Pearson相关性分析结果显示,2组研究对象血清ET-1水平与血清PLGF水平呈负相关(P<0.05)。观察组患者预后不良发生率(20.22%)高于对照组(7.41%),差异有统计学意义(P<0.05)。预后不良组患者病情严重程度为重度例数占比、24 h尿蛋白定量、尿酸、血清ET-1水平高于预后良好组,血清PLGF水平低于预后良好组(P<0.05)。多因素logistic回归分析结果显示,病情严重程度为重度、24 h尿蛋白定量、血清ET-1水平、血清PLGF水平为观察组患者预后不良的危险因素(P<0.05)。ROC曲线分析结果显示,血清ET-1水平与血清PLGF水平预测观察组患者预后不良的AUC值(95% CI)分别为0.825(0.709~0.906)、0.771(0.651~0.852)。结论 子痫前期患者血清ET-1水平高于健康孕妇,而血清PLGF水平低于健康孕妇,二者可用于预测子痫前期患者预后。

Objective To investigate the expression of endothelin-1(ET-1)and placental growth factor(PLGF)in patients with preeclampsia in early pregnancy and its prognostic significance.Methods A total of 89 patients with preeclampsia who were admitted to No.904 Hospital of Joint Logistic Support Force of PLA from March 2019 to May 2021 were assigned to observation group.And 81 healthy pregnant women who underwent physical examination during the same period were enrolled as controls.Their clinical data were retrospectively analyzed.Serum ET-1 and PLGF levels were detected after admission.The correlation between serum ET-1 and PLGF levels was analyzed.All the participants were followed up until term pregnancy,and the prognoses of the two groups were compared.The patients in the observation group were subdivided into good prognosis group and poor prognosis group according to the prognoses.Multivariate logistic regression analysis was used to analyze the risk factors of poor prognosis in patients with preeclampsia.The receiver operating characteristic(ROC)curve was prepared,and the area under the curve(AUC)was used to evaluate the predictive value of serum ET-1 and PLGF levels for poor prognosis of preeclampsia patients.Results Serum ET-1 level in the observation group was higher than that in the control group,while serum PLGF level in the observation group was lower than that in the control group(both P<0.05).Pearson correlation analysis showed that there was a negative correlation between serum ET-1 and PLGF in both groups(P<0.05).The incidence of poor prognosis in the observation group was significantly higher than that in the control group(20.22%vs 7.41%,P<0.05).The proportion of severe cases,24-hour urine protein quantitation,uric acid,and serum ET-1 in the poor prognosis group were higher than those in the good prognosis group,while serum PLGF level in the poor prognosis group was lower than those in the good prognosis group(P<0.05).Multivariate logistic regression analysis showed that severe condition,24-hour urine protein quantitation,serum ET-1 and PLGF levels were risk factors for poor prognosis of preeclampsia patients(all P<0.05).The ROC curve showed that the AUC(95%CI)values of serum ET-1 and PLGF in predicting poor prognosis of preeclampsia were 0.825(0.709-0.906)and 0.771(0.651-0.852),respectively.Conclusion Patients with preeclampsia have higher ET-1 and lower PLGF than healthy pregnant women.Both ET-1 and PLGF can be used to predict the prognosis of patients with preeclampsia.