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妊娠期高血压患者血清ficolin-3、Angptl4水平变化及其临床意义
作者:程红艳  白梅  吴琼  蒋韬 
单位:湖北医药学院附属随州医院妇产科, 湖北 随州 441300
关键词:妊娠期高血压 纤维蛋白胶凝素-3 血管生成素样蛋白4 诊断 
分类号:R714.246
出版年·卷·期(页码):2024·43·第一期(91-96)
摘要:

目的: 探讨妊娠期高血压患者血清纤维蛋白胶凝素-3(ficolin-3)、血管生成素样蛋白4(Angptl4)水平变化及其临床意义。方法: 选取2020年5月至2022年5月在本院接受治疗的102例妊娠期高血压患者作为观察组,根据患者病情,分为高血压组(37例)、轻度子痫前期组(42例)和重度子痫前期组(23例);另选取同一期间102名孕检健康孕妇作为对照组。采用酶联免疫吸附法(ELISA)测定血清ficolin-3、Angptl4水平。采用Pearson相关系数分析血清ficolin-3与Angptl4的相关性;采用受试者工作特征(ROC)曲线检测血清ficolin-3、Angptl4对妊娠期高血压的诊断价值;采用Logistic回归分析妊娠期高血压发生的危险因素。结果: 与对照组比较,观察组血清ficolin-3、Angptl4水平均明显降低(P<0.05)。高血压组、轻度子痫前期组、重度子痫前期组血清ficolin-3、Angptl4水平逐步降低(P<0.05)。观察组患者血清ficolin-3与Angptl4呈正相关(r=0.527,P<0.001)。血清ficolin-3、Angptl4联合诊断妊娠期高血压的ROC曲线下面积(AUC)大于单独诊断的AUC(Z=2.595,P=0.009;Z=5.201,P<0.001)。与对照组比较,观察组血小板计数(PLT)明显降低,血小板平均体积(MPV)、血小板分布宽度(PDW)、血小板聚集率(PagT)明显升高(P<0.05)。血清ficolin-3低表达、Angptl4低表达、PLT低水平、MPV高水平、PDW高水平、PagT高水平是妊娠期高血压发生的危险因素(P<0.05)。结论: 妊娠期高血压患者血清ficolin-3、Angptl4水平均降低,且与妊娠期高血压病情严重程度相关,检测两者水平变化可对妊娠期高血压进行准确评价。

Objective: To investigate the changes and clinical significance of serum levels of ficolin-3 and angiopoietin-like protein 4(Angptl4) in patients with gestational hypertension. Methods: A total of 102 patients with pregnancy induced hypertension who were treated in our hospital from May 2020 to May 2022 were selected as the observation group. According to the patients' condition,they were grouped into hypertension group(37 cases),mild preeclampsia group(42 cases) and severe preeclampsia group(23 cases). Another 102 healthy pregnant women in our hospital were selected as the control group. Serum levels of ficolin-3 and Angptl4 were measured by enzyme-linked immunosorbent assay(ELISA). Pearson correlation was used to analyze the correlation between serum ficolin-3 and Angptl4; the diagnostic value of serum ficolin-3 and Angptl4 in pregnancy induced hypertension was evaluated by ROC curve; multivariate Logistic regression was used to analyze the risk factors of pregnancy induced hypertension. Results: Compared with the control group,the levels of serum ficolin-3 and Angptl4 in the observation group were obviously lower(P<0.05). The levels of serum ficolin-3 and Angptl4 in hypertension group,mild preeclampsia group and severe preeclampsia group decreased gradually(P<0.05). Pearson correlation analysis showed that there was a positive correlation between serum ficolin-3 and Angptl4 in the observation group(r=0.527,P<0.001). The AUC of combined diagnosis of pregnancy induced hypertension by serum ficolin-3 and Angptl4 was higher than that of single diagnosis of pregnancy induced hypertension by serum ficolin-3(Z=2.595,P=0.009) and single diagnosis of pregnancy induced hypertension by serum Angptl4(Z=5.201,P<0.001). Compared with the control group,PLT in the observation group decreased obviously,and MPV,PDW,and PagT increased obviously(P<0.05). Low expression of serum ficolin-3,low expression of Angptl4,low level of PLT,high level of MPV,high level of PDW and high level of PagT were risk factors affecting the occurrence of pregnancy induced hypertension(P<0.05).Conclusion: The serum levels of ficolin-3 and Angptl4 in patients with gestational hypertension are decreased,which are related to the severity of gestational hypertension. Detection of the changes of ficolin-3 and ANGPTL4 can accurately evaluate gestational hypertension.

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