脐血PLGF、RBP-4、irisin与胎儿生长受限的相关性研究-东南大学学报医学版

脐血PLGF、RBP-4、irisin与胎儿生长受限的相关性研究

单位：1. 保定市第二医院产科, 河北保定 071051;
2. 保定市竞秀区妇幼保健院, 河北保定 071000

分类号：R714.51

出版年·卷·期（页码）：2021·40·第五期（640-645）

摘要：

目的：分析脐血胎盘生长因子（PLGF）、视黄醇结合蛋白4（RBP-4）、鸢尾素（irisin）与胎儿生长受限（FGR）的相关性。方法：前瞻性选取2017年9月至2020年7月于保定市第二医院产科分娩的56例FGR孕妇作为FGR组，选取同期于该院分娩的56例正常孕妇（新生儿正常）作为对照组。比较两组脐血血清PLGF、RBP-4、irisin水平，分析FGR发生的影响因素，并经Pearson线性相关分析FGR患儿脐血血清PLGF、RBP-4、irisin与新生儿体质量的相关性。绘制受试者工作特征（ROC）曲线分析脐血血清PLGF、RBP-4、irisin评估FGR的曲线下面积（AUC）。结果：FGR组脐血血清PLGF、RBP-4、irisin水平均低于对照组（P<0.05）。Logistic多因素回归分析提示胎盘异常、羊水过少是FGR发生的危险因素，脐血血清PLGF、RBP-4、irisin水平相对增高是预防FGP的保护性因素（P<0.05）。FGR患者脐血PLGF、RBP-4、irisin水平与新生儿体质量呈正相关（P<0.05）。脐血PLGF、RBP-4、irisin水平单独与其中二者联合评估FGR的AUC分别为0.783、0.726、0.767、0.893。结论：FGR患儿脐血血清PLGF、RBP-4、irisin水平下降，三者水平相对增高可能对预防FGR有一定作用，并且与新生儿体质量存在相关性，有望成为评估FGR的临床指标。

Objective: To analyze the relationship between placental growth factor (PLGF), retinol binding protein 4 (RBP-4), irisin and fetal growth restriction (FGR). Methods: 56 pregnant women with FGR who delivered in the Second Hospital of Baoding from September 2017 to July 2020 were prospectively selected as FGR group, and 56 normal pregnant women (normal newborns) who delivered in our hospital during the same period were selected as control group. The levels of PLGF, RBP-4 and irisin in cord blood of the two groups were compared, and the influencing factors of FGR were analyzed. The correlation between PLGF, RBP-4 and irisin in cord blood and neonatal weight was analyzed by Pearson linear correlation. The receiver operating characteristic(ROC) curve was drawn to analyze the area under the curve (AUC) of cord blood serum PlGF, RBP-4 and irisin to evaluate FGR. Results: The levels of PLGF, RBP-4 and irisin in cord blood of the FGR group were lower than those of the control group. Logistic multivariate regression analysis indicated that abnormal placenta and oligohydramnios were risk factors for FGR, and the relative increase in cord blood serum PLGF, RBP-4, and irisin levels were protective factors to prevent FGP (P<0.05). PLGF, RBP-4, irisin in cord blood of FGR patients were positively correlated with neonatal weight (P<0.05). The AUC of umbilical cord blood PlGF, RBP-4 and irisin in evaluating FGR alone and in combination were 0.783, 0.726, 0.767 and 0.893, respectively. Conclusion: The relative decrease of umbilical serum PLGF, RBP-4 and irisin in FGR patients may prevent FGR and be associated with neonatal weight and is expected to be a clinical indicator of FGR.

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