摘要
目的 探讨子痫前期(PE)患者血清人类白细胞抗原-G(HLA-G)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平及其与围生结局的关系。方法 选择2022年1月至2024年2月该院收治的98例PE患者作为PE组,其中轻度PE组65例、重度PE组33例。另选择同期在该院进行产前检查的105例健康孕妇作为对照组。采用酶联免疫吸附试验检测所有受试者血清HLA-G、LP-PLA2水平;调查PE患者的围生结局并分为围生结局不良组和围生结局良好组;采用多因素Logistic回归分析PE患者围生结局不良的影响因素;绘制受试者工作特征(ROC)曲线分析血清HLA-G、LP-PLA2对PE患者围生结局不良的预测价值。结果 PE组血清HLA-G水平低于对照组(P<0.05),LP-PLA2水平高于对照组(P<0.05)。重度PE组血清HLA-G水平低于轻度PE组(P<0.05),LP-PLA2水平高于轻度PE组(P<0.05)。围生结局不良组26例,围生结局良好组72例。围生结局不良组血清HLA-G水平低于围生结局良好组(P<0.05),LP-PLA2水平高于围生结局良好组(P<0.05)。多因素Logistic回归分析结果显示,血清LP-PLA2水平升高是PE患者围生结局不良的危险因素(P<0.05),血清HLA-G水平升高是PE患者围生结局不良的保护因素(P<0.05)。ROC曲线分析结果显示,血清HLA-G、LP-PLA2单独及联合预测PE患者围生结局不良的AUC分别为0.896、0.884、0.965,2项联合预测的AUC大于血清HLA-G(Z=2.074,P=0.038)、LP-PLA2(Z=2.114,P=0.035)单独预测的AUC。结论 PE患者血清HLA-G水平降低、LP-PLA2水平升高,二者是PE患者围生结局不良的影响因素,2项联合对PE患者围生结局不良的预测价值高。
Objective To investigate the serum human leukocyte antigen-G(HLA-G)and lipoprotein-associated phospholipase A2(Lp-PLA2)levels in the patients with preeclampsia(PE)and their relationship with perinatal outcomes.Methods A total of 98 patients with PE admitted and treated in this hospital from January 2022 to February 2024 were selected as the PE group,including 65 cases in the mild PE subgroup and 33 cases in the severe PE subgroup.The other 105 healthy pregnant women who underwent the prenatal examinations in this hospital during the same period were selected as the control group.The serum HLA-G and LP-PLA2 levels in all subjects were detected by the enzyme-linked immunosorbent assay.The perinatal outcomes of PE patients were investigated and divided into the poor perinatal outcome group and good perinatal outcome group.The multivariate Logistic regression was used to analyze the influencing factors for the poor perinatal outcomes occurrence in PE patients.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum HLA-G and LP-PLA2 for the poor perinatal outcomes in PE patients.Results The serum HLA-G level in the PE group was lower than that in the control group(P<0.05),and the LP-PLA2 level was higher than that in the control group(P<0.05).The serum HLA-G level in the severe PE subgroup was lower than that in the mild PE subgroup(P<0.05),and the LP-PLA2 level was higher than that in the mild PE subgroup(P<0.05).There were 26 cases in the poor perinatal outcome group and 72 cases in the good perinatal outcome group.The serum HLA-G level in the poor perinatal outcome group was lower than that in the good perinatal outcome group(P<0.05),and the LP-PLA2 level was higher than that in the good perinatal outcome group(P<0.05).The multivariate Logistic regression analysis results showed that increased serum LP-PLA2 level was a risk factor for poor perinatal outcomes in PE patients(P<0.05),and increased serum HLA-G level was a protective factor for poor perinatal outcomes in PE patients(P<0.05).The results of ROC curve analysis showed that the areas under the curves(AUCs)of serum HLA-G,LP-PLA2 alone and their combination for predicting the poor perinatal outcomes in PE patients were 0.896,0.884 and 0.965 respectively.The AUC of the 2-item combination prediction was greater than the AUC of serum HLA-G(Z=2.074,P=0.038)and LP-PLA2(Z=2.114,P=0.035)alone.Conclusion The serum HLA-G level is decreased and the LP-PLA2 level is increased in PE patients.The two are the influencing factors for poor perinatal outcomes occurrence in PE patients.The 2-item combination prediction has a high predictive value for poor perinatal outcomes occurrence in PE patients.
作者
胡小娜
郭敏
熊杰
刘莉
宋志慧
HU Xiaona;GUO Min;XIONG Jie;LIU Li;SONG Zhihui(Department of Obstetrics,Tangshan Municipal Maternal and Child Healthcare Hospital,Tangshan,Hebei 063000,China)
出处
《检验医学与临床》
2025年第22期3142-3146,3151,共6页
Laboratory Medicine and Clinic
基金
河北省卫生健康委员会医学科学研究课题计划项目(20231747)。
