金属肽酶含血小板反应蛋白1作为妊娠剧吐诊断标志物的可行性研究

Feasibility study of a disintegrin and metalloproteinase with thrombospondin motifs-1 as a diagnostic marker for hyperemesis gravidarum

摘要

目的 研究金属肽酶含血小板反应蛋白1(ADAMTS-1)作为妊娠剧吐(HG)诊断标志物的可行性。方法 选取海口市人民医院2019年1月至2022年1月收治的100名孕妇作为研究对象.诊断为妊娠剧吐的49例患者作为实验组,另外51名健康孕妇为对照组.比较两组外周血清的ADAMTS-1表达水平及孕妇的一般资料、临床特征和生化指标,并评估外周血清ADAMTS-1表达水平和尿酮症之间的相关性。结果 实验组的尿酮、血糖、谷丙转氨酶、中性粒细胞计数、血小板比积、血小板平均体积、降钙素原、血小板分布宽度和ADAMTS-1水平高于对照组且具有显著统计学意义(t值分别为0．000、-2．490、-2．780、-3．024、-2．674、-2．978、-7．595、-19．812、-11．596,P＜0．05);ADAMTS-1与患者尿酮、谷丙转氨酶、中性粒细胞计数、血小板平均体积、降钙素原、血小板分布宽度显著正相关(r值分别为0．58、0．22、0．21、0．22、0．51、0．66,P＜0．05),与患者红细胞平均体积和促甲状腺激素显著负相关(r值分别为-0．23、-0．32,P＜0．05);使用ADAMTS-1诊断妊娠剧吐的受试者工作特征曲线(ROC)曲线下面积(AUC)为0．94(95％CI＝0．88~1．00,P＜0．05),ADAMTS-1的临界值为9．48ng/mL,灵敏度为85．71％,特异性为98．04％。结论 HG患者的血清ADAMTS-1显著升高,可作为妊娠剧吐的有效生物标志物.

Abstract

Objective To study the feasibility of a disintegrin and metalloproteinase with thrombospondin motifs-1 (ADAMTS-1) as a diagnostic marker for hyperemesis gravidarum (HG). Methods A total of 100 pregnant women admitted to Haikou People's Hospital from January 2019 to January 2022 were selected as the study subjects. Among them, 49 patients diagnosed with hyperemesis gravidarum were the experimental group, and the other 51 healthy pregnant women were the control group. Peripheral serum ADAMTS-1 expression levels and general information and clinical characteristics, biochemical indicators of pregnant women were compared between the two groups, and the correlation between peripheral serum ADAMTS-1 expression levels and urinary ketosis was assessed. Results The levels of urinary ketones, blood glucose, glutamic-pyruvic transaminase, neutrophil count, plateletocrit, mean platelet volume, procalcitonin, platelet distribution width and ADAMTS-1 were higher in the experimental group than those in the control group, the differences were statistically significant (t=0.000, -2.490, -2.780, -3.024, -2.674, -2.978, -7.595, -19.812 and -11.596, respectively, P<0.05). ADAMTS-1 was significantly positively correlated with urinary ketones, glutamic-pyruvic transaminase, neutrophil count, mean platelet volume, procalcitonin and platelet distribution width (r=0.58, 0.22, 0.21, 0.22, 0.51 and 0.66, respectively, P<0.05), and negatively correlated with mean corpuscular volume and thyroid stimulating hormone (r=-0.23 and -0.32, respectively, P<0.05). The area under the curve (AUC) of the receiver operating characteristic (ROC) curve of the subjects using peripheral ADAMTS-1 for diagnosis of hyperemesis gravidarum was 0.94 (95%CI=0.88-1.00, P<0.05), the critical value of ADAMTS-1 was 9.48ng/mL, with a sensitivity of 85.71% and a specificity of 98.04%. Conclusion Serum ADAMTS-1 is significantly elevated in patients with HG and can be used as a valid biomarker for hyperemesis gravidarum.

关键词

ADAMTS-1 / 妊娠剧吐 / 孕妇 / 外周血

Key words

ADAMTS-1 / hyperemesis gravidarum / gravida / peripheral blood

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基金资助

海南省2020年自然科学基金青年项目(820QN424)

海南省2021年自然科学基金青年项目(821QN423)