摘要
目的探究妊娠期高血压疾病患者血清血小板内皮细胞黏附分子-1(PECAM-1)、一氧化氮(NO)水平及临床意义。方法选取2022年6月至2024年6月河北北方学院附属第二医院120例妊娠期高血压疾病患者作为研究组(包括妊娠期高血压70例,轻度子痫前期34例,重度子痫前期16例),同期产检的120例健康孕妇为对照组。比较研究组和对照组血清PECAM-1、NO水平,以及不同类型妊娠期高血压疾病患者血清PECAM-1、NO水平,绘制受试者工作特征(ROC)曲线分析血清PECAM-1、NO水平诊断妊娠期高血压疾病的价值。对研究组患者随访至分娩,根据分娩结局分为结局良好组(98例)和结局不良组(22例),比较两组患者临床资料及血清PECAM-1、NO水平,使用Logistic回归分析患者不良分娩结局的影响因素。结果研究组血清PECAM-1、NO水平低于对照组(P<0.05);不同类型妊娠期高血压疾病患者血清PECAM-1、NO水平存在差异(P<0.05),其中妊娠期高血压>轻度子痫前期>重度子痫前期;ROC曲线分析显示,血清PECAM-1、NO水平诊断妊娠期高血压疾病的曲线下面积(AUC)为0.852、0.819,二者联合诊断AUC为0.939,联合诊断价值高于单一指标(P<0.05);结局良好组与结局不良组患者疾病程度、24 h尿蛋白定量、收缩压、舒张压、年龄、身体质量指数、血清PECAM-1、NO水平比较,差异均有统计学意义(P<0.05);Logistic回归分析显示,疾病程度、24 h尿蛋白定量、收缩压、年龄、PECAM-1、NO水平是妊娠期高血压疾病患者不良分娩结局的影响因素(P<0.05)。结论妊娠期高血压疾病患者血清PECAM-1、NO水平较健康孕妇下降,二者联合对妊娠期高血压疾病的诊断效能高,且与不良分娩结局相关。
Objective To investigate the levels and clinical significance of serum platelet endothelial cell adhesion molecule-1(PECAM-1)and nitric oxide(NO)in patients with hypertensive disorder complicating pregnancy(HDCP).Methods A total of 120 HDCP patients admitted to Hebei North University Affiliated Second Hospital from June 2022 to June 2024 were selected as the study group(including 70 cases of gestational hypertension,34 cases of mild preeclampsia,and 16 cases of severe preeclampsia),with 120 healthy pregnant women undergoing prenatal examination during the same period as the control group.Serum PECAM-1 and NO levels were compared between the study group and the control group,as well as among different types of HDCP patients.Receiver operating characteristic(ROC)curves were plotted to analyze the diagnostic value of serum PECAM-1 and NO levels for HDCP.Patients in the study group were followed until delivery and divided into good outcome group(n=98)and poor outcome group(n=22)based on delivery outcomes.Basic data and serum PECAM-1,NO levels were compared between these two groups,and logistic regression analysis was used to identify influencing factors for poor delivery outcomes.Results Serum PECAM-1 and NO levels in the study group were lower than those in the control group(P<0.05).Significant differences existed in these levels among HDCP subtypes(P<0.05),with the order:gestational hypertension>mild preeclampsia>severe preeclampsia.ROC analysis showed that the areas under the curve(AUC)for diagnosing HDCP were 0.852 for PECAM-1 and 0.819 for NO;the combined AUC was 0.939.The diagnostic value of the combination was significantly higher than that of individual indicators(P<0.05).Statistically significant differences(P<0.05)were observed between the good and poor outcome groups in disease severity,24-hour urinary protein quantification,systolic blood pressure,diastolic blood pressure,age,body mass index(BMI),and serum PECAM-1,NO levels.Logistic regression analysis confirmed that disease severity,24-hour urinary protein quantification,systolic blood pressure,age,PECAM-1,and NO levels were influencing factors for poor delivery outcomes in HDCP patients(P<0.05).Conclusion Serum PECAM-1 and NO levels are decreased in HDCP patients compared to healthy pregnant women.Their combination demonstrates high diagnostic efficiency for HDCP and correlates with poor delivery outcomes.
作者
田秀娟
杨恩亮
全慧
祁广晶
任熙
李聪颖
武莉芳
闫利荣
陈云飞
苏心镜
TIAN Xiujuan;YANG Enliang;QUAN Hui;QI Guangjing;REN Xi;LI Congying;WU Lifang;YAN Lirong;CHEN Yunfei;SU Xinjing(Department of Obstetrics,The Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China;Department of Anesthesiology,The Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China;Department of Outpatient,The Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China;Department of Gynecology,The Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China;Department of Laboratory Medicine,The Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China)
出处
《转化医学杂志》
2025年第7期111-116,共6页
Translational Medicine Journal
基金
河北省医学科学研究课题计划项目(20210125)。
