妊娠期高血压患者血清ficolin-3、Angptl4水平变化及其临床意义-东南大学学报医学版

妊娠期高血压患者血清ficolin-3、Angptl4水平变化及其临床意义

单位：湖北医药学院附属随州医院妇产科, 湖北随州 441300

分类号：R714.246

出版年·卷·期（页码）：2024·43·第一期（91-96）

摘要：

目的: 探讨妊娠期高血压患者血清纤维蛋白胶凝素-3(ficolin-3)、血管生成素样蛋白4(Angptl4)水平变化及其临床意义。方法: 选取2020年5月至2022年5月在本院接受治疗的102例妊娠期高血压患者作为观察组,根据患者病情,分为高血压组(37例)、轻度子痫前期组(42例)和重度子痫前期组(23例);另选取同一期间102名孕检健康孕妇作为对照组。采用酶联免疫吸附法(ELISA)测定血清ficolin-3、Angptl4水平。采用Pearson相关系数分析血清ficolin-3与Angptl4的相关性;采用受试者工作特征(ROC)曲线检测血清ficolin-3、Angptl4对妊娠期高血压的诊断价值;采用Logistic回归分析妊娠期高血压发生的危险因素。结果: 与对照组比较,观察组血清ficolin-3、Angptl4水平均明显降低(P<0.05)。高血压组、轻度子痫前期组、重度子痫前期组血清ficolin-3、Angptl4水平逐步降低(P<0.05)。观察组患者血清ficolin-3与Angptl4呈正相关(r=0.527,P<0.001)。血清ficolin-3、Angptl4联合诊断妊娠期高血压的ROC曲线下面积(AUC)大于单独诊断的AUC(Z=2.595,P=0.009;Z=5.201,P<0.001)。与对照组比较,观察组血小板计数(PLT)明显降低,血小板平均体积(MPV)、血小板分布宽度(PDW)、血小板聚集率(PagT)明显升高(P<0.05)。血清ficolin-3低表达、Angptl4低表达、PLT低水平、MPV高水平、PDW高水平、PagT高水平是妊娠期高血压发生的危险因素(P<0.05)。结论: 妊娠期高血压患者血清ficolin-3、Angptl4水平均降低,且与妊娠期高血压病情严重程度相关,检测两者水平变化可对妊娠期高血压进行准确评价。

Objective: To investigate the changes and clinical significance of serum levels of ficolin-3 and angiopoietin-like protein 4(Angptl4) in patients with gestational hypertension. Methods: A total of 102 patients with pregnancy induced hypertension who were treated in our hospital from May 2020 to May 2022 were selected as the observation group. According to the patients' condition,they were grouped into hypertension group(37 cases),mild preeclampsia group(42 cases) and severe preeclampsia group(23 cases). Another 102 healthy pregnant women in our hospital were selected as the control group. Serum levels of ficolin-3 and Angptl4 were measured by enzyme-linked immunosorbent assay(ELISA). Pearson correlation was used to analyze the correlation between serum ficolin-3 and Angptl4; the diagnostic value of serum ficolin-3 and Angptl4 in pregnancy induced hypertension was evaluated by ROC curve; multivariate Logistic regression was used to analyze the risk factors of pregnancy induced hypertension. Results: Compared with the control group,the levels of serum ficolin-3 and Angptl4 in the observation group were obviously lower(P<0.05). The levels of serum ficolin-3 and Angptl4 in hypertension group,mild preeclampsia group and severe preeclampsia group decreased gradually(P<0.05). Pearson correlation analysis showed that there was a positive correlation between serum ficolin-3 and Angptl4 in the observation group(r=0.527,P<0.001). The AUC of combined diagnosis of pregnancy induced hypertension by serum ficolin-3 and Angptl4 was higher than that of single diagnosis of pregnancy induced hypertension by serum ficolin-3(Z=2.595,P=0.009) and single diagnosis of pregnancy induced hypertension by serum Angptl4(Z=5.201,P<0.001). Compared with the control group,PLT in the observation group decreased obviously,and MPV,PDW,and PagT increased obviously(P<0.05). Low expression of serum ficolin-3,low expression of Angptl4,low level of PLT,high level of MPV,high level of PDW and high level of PagT were risk factors affecting the occurrence of pregnancy induced hypertension(P<0.05).Conclusion: The serum levels of ficolin-3 and Angptl4 in patients with gestational hypertension are decreased,which are related to the severity of gestational hypertension. Detection of the changes of ficolin-3 and ANGPTL4 can accurately evaluate gestational hypertension.

参考文献：

[1] 彭博,段超超,王春芳.妊娠期高血压疾病视网膜病变的研究现状[J].中西医结合心脑血管病杂志,2021,19(10):1659-1661.
[2] 王妍,王立媛,王静.心痛定联合拉贝洛尔治疗妊娠期高血压疾病效果及患者血清IGF-1、HSP70水平变化[J].山东医药,2021,61(5):72-75.
[3] LEI F,LIU D,SHEN Y,et al.Study on the influence of pregnancy-induced hypertension on neonatal birth weight[J].J Investig Med,2018,66(6):1008-1014.
[4] 曲垟霖,王巍,王强.妊娠期高血压疾病血压控制水平与妊娠结局相关综述分析[J].中国妇幼保健,2018,33(11):2632-2635.
[5] 李明星,谢冰秀,张康婧,等.血清sFRP4和ficolin-3水平与妊娠期糖尿病的相关性研究[J].河北医药,2019,41(19):2951-2954.
[6] MANCUSI C,IZZO R,DI GIOIA G,et al.Insulin resistance the hinge between hypertension and type 2 diabetes[J].High Blood Press Cardiovasc Prev,2020,27(6):515-526.
[7] ALEJANDRO E U,BERNLOHR D A.Window of opportunity:targeting ANGPTL4 improves triglyceride levels in maternal obesity during pregnancy[J].Diabetes,2020,69(6):1087-1089.
[8] 中华医学会妇产科学分会妊娠期高血压疾病学组.妊娠期高血压疾病诊治指南(2020)[J].中华妇产科杂志,2020,55(4):227-238.
[9] YAN Y,LUAN L,XU J.Serum expression of ESM-1,HMWA,and AGEs and its relationship with disease severity in patients with gestational hypertension[J].Comput Math Methods Med,2021,2021(5):9545857-9545862.
[10] 李丽,罗晓梅,张媛媛,等.血清血栓调节蛋白、类血管生成素6和β-痕迹蛋白对妊娠期高血压疾病的诊断价值[J].现代医学,2020,48(10):1276-1279.
[11] JIN Y,XU H,WU M,et al.Correlation of gestational hypertension with abnormal lipid metabolism,insulin resistance and D-dimer and their clinical significance[J].Exp Ther Med,2019,17(2):1346-1350.
[12] YUAN X S,SHI H,WANG H Y,et al.Ficolin-3/adiponectin ratio for the prediction of gestational diabetes mellitus in pregnant women[J].Diabetes Investig,2018,9(2):403-410.
[13] 李桂新,刘士平,徐裕海,等.原发性高血压患者血清ficolin-3、免疫球蛋白、补体及CRP水平研究[J].大连医科大学学报,2016,38(4):367-370.
[14] LORENZO-ALMORÓS A,HANG T,PEIRÓ C,et al.Predictive and diagnostic biomarkers for gestational diabetes and its associated metabolic and cardiovascular diseases[J].Cardiovasc Diabetol,2019,18(1):140-156.
[15] 林桐梅,高笛.原发性高血压患者血清纤维蛋白胶凝素3水平与颈动脉粥样硬化的相关性研究[J].中华老年心脑血管病杂志,2019,21(6):600-604.
[16] 贾耀辉,陈慧敏,代永庆,等.血清硫氧还蛋白1及纤维胶凝蛋白3水平与老年高血压脑出血患者血肿周围水肿和预后的关系研究[J].中国实用神经疾病杂志,2021,24(21):1889-1899.
[17] 黄志明,王研.血清血管生成素样蛋白水平与冠心病患者Gensini积分的相关性分析[J].心肺血管病杂志,2019,38(8):826-829,847.
[18] 许磊,康亚宁,马静,等.老年2型糖尿病合并高血压患者血管生成素样蛋白4、同型半胱氨酸、血脂水平与颈动脉粥样硬化严重程度的相关性分析[J].中国医学前沿杂志(电子版),2019,11(9):98-102.
[19] 胡丹丹,林霞,曾建.血清脂肪因子血管生成素样蛋白4水平与2型糖尿病下肢血管病变的相关性研究[J].中国糖尿病杂志,2019,27(6):434-437.
[20] 黎鹏飞,刘宗涛,刘涛,等.冠心病患者血清血管生成素样蛋白4水平检测分析[J].微循环学杂志,2020,30(2):49-52.
[21] LIU L,ZHUANG X,JIANG M,et al.ANGPTL4 mediates the protective role of PPARγ activators in the pathogenesis of preeclampsia[J].Cell Death Dis,2017,8(9):e3054-e3066.
[22] LI N,LIU Y,YUN A,et al.Correlation of platelet function with postpartum hemorrhage and venous thromboembolism in patients with gestational hypertension complicated with diabetes[J].Comput Math Methods Med,2022,2022(10):2423333-2423341.
[23] 李姗姗,张琛,颜景玲.妊娠期高血压疾病患者血清LRRFIP1水平与血小板功能的关系[J].中国医药导报,2019,16(33):92-95.
[24] BELMONTE B,MANGOGNA A,GULINO A,et al.Distinct roles of classical and lectin pathways of complement in preeclamptic placentae[J].Front Immunol,2022,13(1):882298-882310.

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