妊娠期高血压孕妇血清SerpinB1、SFRP5水平及与妊娠结局的关系

The levels of serum SerpinB1 and SFRP5 of pregnant women with gestational hypertension and their association with pregnancy outcomes

摘要

目的 探讨妊娠期高血压疾病(HDP)孕妇血清分泌型卷曲相关蛋白5(SFRP5)、丝氨酸蛋白酶抑制剂B1(SerpinB1)水平,以及二者与妊娠结局的关系。方法 选取2020年6月至2022年6月于青岛市妇女儿童医院就诊的132例HDP孕妇作为研究组,另选取140例同一时期孕检的健康孕妇作为对照组,采用酶联免疫吸附法(ELISA)检测血清两组SerpinB1、SFRP5水平.依据妊娠结局将研究组孕妇分为良好组(n=106)和不良组(n=26).Logistic回归分析影响HDP孕妇发生不良妊娠结局的相关因素;受试者工作特征(ROC)曲线评估血清SerpinB1、SFRP5水平对HDP孕妇发生妊娠不良结局的预测价值。结果 研究组孕妇初产、吸烟史、酗酒史、孕妇子痫前期史、子痫前期家族史所占比例及甘油三酯、收缩压、舒张压、血清SerpinB1均高于对照组,血清SFRP5低于对照组,差异有统计学意义(χ²/t值介于2.866~30.978之间,P<0.05);研究组孕妇胎膜早破、羊水异常、宫缩乏力发生率均高于对照组,差异有统计学意义(χ²值分别为11.005、4.686、4.306,P<0.05);HDP孕妇妊娠结局良好组收缩压、舒张压、血清SerpinB1均低于不良组,血清SFRP5高于不良组,差异有统计学意义(t值介于2.581~6.453之间,P<0.05);Logistic回归结果显示血清SerpinB1为影响HDP孕妇发生不良结局的危险因素,SFRP5是保护因素(OR值分别为3.328、0.618,P<0.05);血清SerpinB1、SFRP5及二者联合预测HDP孕妇发生不良妊娠结局的曲线下面积(AUC)分别为0.775、0.879、0.968,二者联合优于血清SerpinB1、SFRP5各自单独预测(Z值分别为3.866、2.372,P<0.05)。结论 HDP孕妇血清SerpinB1水平显著升高,血清SFRP5水平显著降低,二者与孕妇妊娠结局联系密切,且二者联合对HDP孕妇发生妊娠不良结局有一定的预测价值.

Abstract

Objective To investigate the levels of serum secreted frizzle-associated protein 5 (SFRP5) and serine protease inhibitor B1 (SerpinB1) in pregnant women with gestational hypertension (HDP) and their relationship with pregnancy outcomes. Methods A total of 132 pregnant women with HDP who were admitted to Qingdao Women and Children's Hospital from June 2020 to June 2022 were collected as the study group, and 140 healthy pregnant women with pregnancy tests at the same period were selected as the control group. Enzyme linked immunosorbent assay (ELISA) was applied to detect the expression levels of SerpinB1 and SFRP5 in serum. According to the pregnancy outcomes, pregnant women in the study group were divided into good group (n=106) and poor group (n=26). Logistic regression analysis was performed to analyze the factors affecting adverse pregnancy outcomes in pregnant women with HDP. The receiver operating characteristic (ROC) curve evaluated the predictive value of serum SerpinB1 and SFRP5 levels in adverse pregnancy outcomes in pregnant women with HDP. Results The proportions of primiparity, smoking history, alcoholism history, preeclampsia history, preeclampsia family history, triglyceride, systolic blood pressure, diastolic blood pressure and serum SerpinB1 in the study group were higher than those in the control group, and the serum SFRP5 was lower than that in the control group, and the differences were statistically significant (χ²/t values were between 2.866~30.978, P<0.05). The incidences of premature rupture of membranes, abnormal amniotic fluid and uterine atony in the study group were higher than those in the control group, and the differences were statistically significant (χ²=11.005, 4.686, 4.306, P<0.05). The systolic blood pressure, diastolic blood pressure and serum SerpinB1 in the good pregnancy outcome group were lower than those in the poor pregnancy outcome group, and the serum SFRP5 was higher than that in the poor pregnancy outcome group, and the differences were statistically significant (t values were between 2.581 and 6.453, P<0.05). Logistic regression showed that serum SerpinB1 was a risk factor for adverse outcomes in pregnant women with HDP, and SFRP5 was a protective factor (OR=3.328, 0.618, respectively, P<0.05). The area under the curve (AUC) of SerpinB1, SFRP5 and their combination in predicting adverse pregnancy outcomes in pregnant women with HDP were 0.775, 0.879 and 0.968, respectively, and the combination of SerpinB1 and SFRP5 was better than serum SerPINB1 and SFRP5 alone (Z=3.866, 2.372, respectively, P<0.05). Conclusion The serum SerpinB1 level in pregnant women with HDP obviously increases, while the serum SFRP5 level obviously decreases. The two are closely related to the pregnancy outcomes of pregnant women, and the combination of the two has a certain predictive value for adverse pregnancy outcomes in HDP pregnant women.

关键词

妊娠期高血压疾病 / 丝氨酸蛋白酶抑制剂B1 / 分泌型卷曲相关蛋白5 / 妊娠结局

Key words

hypertensive disorders of pregnancy / serine protease inhibitor B1 / secreted frizzled related protein 5 / pregnancy outcomes

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