妊娠期高血压疾病患者血清sFlt-1、ESM-1及AGEs表达水平及临床意义

Expression levels and clinical significance of serum sFlt-1, ESM-1 and AGEs in patients with hypertensive disorders of pregnancy

摘要

目的 探讨妊娠期高血压疾病(HDP)患者血清可溶性血管内皮生长因子受体-1(sFlt-1)、内皮细胞特异分子-1(ESM-1)及晚期糖基化终末产物(AGEs)的表达及临床意义。方法 选取2020年1月至2022年12月上海儿童医学中心海南医院收治的192例HDP患者(HDP组)和50例健康孕妇(对照组),检测血清sFlt-1、ESM-1及AGEs水平。HDP患者包括妊娠期高血压(GH)43例,慢性高血压合并妊娠(CHDP)26例,子痫前期(PE)92例,慢性高血压并发子痫前期(PSOCH)31例。根据妊娠结局情况分为不良妊娠结局(68例)和妊娠结局良好(124例)。绘制受试者工作特征(ROC)曲线分析血清sFlt-1、ESM-1及AGEs水平对HDP患者妊娠结局的预测价值。结果 HDP组血清sFlt-1、ESM-1及AGEs水平均明显高于对照组(t=25.713、11.125、18.260,P<0.001)。PSOCH组和PE组血清sFlt-1、ESM-1及AGEs水平均明显高于GH组和CHDP组,差异均有统计学意义(P<0.001)。不良妊娠结局组血清sFlt-1、ESM-1及AGEs水平均明显高于妊娠结局良好组(t=30.915、14.813、19.628,P<0.001)。ROC曲线分析显示,sFlt-1、ESM-1及AGEs预测HDP患者不良妊娠结局的曲线下面积(AUC)分别为0.866、0.801、0.857,sFlt-1、ESM-1及AGEs联合的AUC=0.951。结论 血清sFlt-1、ESM-1及AGEs水平在HDP患者明显升高,与HDP严重程度有关,sFlt-1、ESM-1及AGEs联合可用于评估HDP患者不良妊娠结局发生。

Abstract

Objective To investigate the expression and clinical significance of serum soluble fms-like tyrosine kinase-1 (sFlt-1), endothelial cell specific molecule-1 (ESM-1) and advanced glycation end products (AGEs) in patients with hypertensive disorders of pregnancy (HDP). Methods 192 patients with hypertensive disorders of pregnancy (HDP group) and 50 healthy pregnant women (control group) who were treated at Hainan Hospital, Shanghai Children's Medical Center, from January 2020 to December 2022, were selected to detect the serum levels of sFlt-1, ESM-1, and AGEs. HDP patients included 43 cases of gestational hypertension (GH), 26 cases of chronic hypertension complicated with pregnancy (CHDP), 92 cases of preeclampsia (PE) and 31 cases of preeclampsia superimposed on chronic hypertension (PSOCH). According to the pregnancy outcomes, the patients were divided into adverse pregnancy outcomes (68 cases) and good pregnancy outcomes (124 cases). Receiver operating characteristic (ROC) curves were drawn to analyze the predictive value of serum sFlt-1, ESM-1 and AGEs levels for pregnancy outcomes in HDP patients. Results The levels of serum sFlt-1, ESM-1 and AGEs in HDP group were significantly higher than those in the control group (t=25.713, 11.125 and 18.260, respectively, P<0.001). The levels of serum sFlt-1, ESM-1 and AGEs in the PSOCH and PE groups were significantly higher than those in the GH and CHDP groups, with statistically significant differences (P<0.001). The levels of serum sFlt-1, ESM-1 and AGEs in the adverse pregnancy outcome group were significantly higher than those in the good pregnancy outcome group (t=30.915, 14.813, 19.628, respectively, P<0.001). ROC curve analysis showed that the area under the curve (AUC) for predicting adverse pregnancy outcomes in HDP patients was 0.866 for sFlt-1, 0.801 for ESM-1, and 0.857 for AGEs, with a combined AUC of 0.951 for sFlt-1, ESM-1, and AGEs. Conclusion The levels of serum sFlt-1, ESM-1, and AGEs are significantly increased in HDP patients and are related to the severity of HDP. The combination of sFlt-1, ESM-1, and AGEs can be used to evaluate the occurrence of adverse pregnancy outcomes in HDP patients.

关键词

妊娠期高血压 / 可溶性血管内皮生长因子受体-1 / 内皮细胞特异分子-1 / 晚期糖基化终末产物

Key words

hypertensive disorder of pregnancy / soluble fms-like tyrosine kinase-1 / endothelial cell specific molecule-1 / advanced glycosylation end product

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基金资助

海南省临床医学中心建设项目(琼卫(2021)75号)