摘要
目的:探讨子痫前期(PE)患者血清叉头盒蛋白A1(FOXA1)、肿瘤坏死因子受体相关因子6(TRAF6)水平及其对不良妊娠结局的预测价值。方法:选取2019年1月-2022年1月于本院就诊并分娩的PE患者164例临床资料,根据疾病严重程度分为轻度PE组和重度PE组,根据患者是否发生不良妊娠结局分为不良组和良好组;另选取同期产前检查并分娩的健康孕妇60例作为对照组。分析各组临床资料、血清FOXA1 mRNA、TRAF6 mRNA、肌钙蛋白I(cTnI)、抗心磷脂抗体(ACA)-IgM、ACA-IgG水平;Pearson相关分析指标间相关性;受试者工作特征曲线(ROC曲线)分析血清FOXA1 mRNA、TRAF6 mRNA对PE患者不良妊娠结局的预测价值;多因素logistic回归分析影响PE患者不良妊娠结局的因素。结果:对照组、轻度PE组、重度PE组收缩压、舒张压、24 h尿蛋白及TRAF6 mRNA(0.99±0.10、1.58±0.22、1.97±0.26)、cTnI、ACA-IgM、ACA-IgG水平依次升高,血清FOXA1 mRNA(1.02±0.11、0.69±0.09、0.56±0.08)依次降低(均P<0.05);轻度PE患者、重度PE患者cTnI、ACA-IgM、ACA-IgG、收缩压、舒张压、24 h尿蛋白与FOXA1 mRNA水平呈负相关,与TRAF6 mRNA水平呈正相关(P<0.05);不良组收缩压、舒张压、24 h尿蛋白及血清TRAF6 mRNA、cTnI、ACA-IgM、ACA-IgG水平均高于良好组,血清FOXA1 mRNA水平低于良好组(P<0.05);血清FOXA1 mRNA、TRAF6 mRNA水平及二者联合预测PE患者不良妊娠结局的曲线下面积(AUC)分别为0.824、0.766、0.889;24 h尿蛋白、TRAF6 mRNA、ACA-IgG升高,FOXA1 mRNA降低是PE患者发生不良妊娠结局的独立影响因素(P<0.05)。结论:PE患者血清FOXA1 mRNA、TRAF6 mRNA水平发生异常,且均与疾病严重程度及不良妊娠结局有关,具有预测不良妊娠结局价值且二者联合预测价值更高。
Objective:To investigate the serum levels of forkhead box protein A1(FOXA1)and tumor necrosis factor receptor-associated factor 6(TRAF6)of pregnant women with preeclampsia(PE),and to study their predictive value for the pregnancy outcomes of these women.Methods:The clinical data of 164 pregnant women with PE who had given birth from January 2019 to January 2022 were selected in study group.These women were divided into group A(women with mild PE)and group B(women with severe PE)according to the severity of PE.These women were also divided into group C(women with adverse pregnancy outcomes)and group D(women with normal pregnancy outcomes)according to the pregnancy outcomes of the women.Another 60 healthy pregnant women who underwent physical examination and gave birth were selected in control group.The clinical data,the levels of serum FOXA1 mRNA,TRAF6 mRNA,troponin I(cTnI),anticardiolipin antibody(ACA)-IgM,and ACA-IgG of these women were analyzed.Pearson correlation coefficient was performed to analyze the correlation among the different indicators.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of the levels of the serum FOXA1 mRNA and TRAF6 mRNA of the women with PE for their adverse pregnancy outcomes.Multivariate logistic regression was performed to analyze the factors affecting the adverse pregnancy outcomes of the women with PE.Results:The values of systolic blood pressure and diastolic blood pressure,and the levels of 24h urine protein,cTnI,ACA-IgM,and ACA-IgG of the women in control group,in group A and group B had increased successively,and the level of serum TRAF6 mRNA of the women in control group,in group A,and in group B had increased successively,which was 0.99±0.10,1.58±0.22,and 1.97±0.26,respectively.The level of serum FOXA1 mRNA of the women in control group,in group A,and in group B had increased successively,which were 1.02±0.11,0.69±0.09,and 0.56±0.08,respectively(all P<0.05).The levels of cTnI,ACA-IgM,and ACA-IgG,and the values of systolic and diastolic blood pressure,and 24 h urinary protein of the women in groups A and B were negatively correlated with their FOXA1 mRNA level,and was positively correlated with their TRAF6 mRNA level(P<0.05).The values of systolic and diastolic blood pressure,24 h urine protein,and the levels of serum TRAF6 mRNA,cTnI,ACA-IgM,and ACA-IgG of the women in group C were significantly higher than those of the women in group D,and the serum FOXA1 mRNA level of the women in group C was significantly lower than that of the women in group D(P<0.05).The area under curve(AUC)of the serum FOXA1 mRNA,TRAF6 mRNA,and the combination of serum FOXA1 mRNA and TRAF6 mRNA levels of the women with PE for predicting their adverse pregnancy outcomes were 0.824,0.766,and 0.889,respectively.The increases of 24h urinary protein,TRAF6 mRNA,and ACA-IgG,and the decreases of FOXA1 mRNA of the women with PE were the independent influencing factors of their adverse pregnancy outcomes(P<0.05).Conclusion:The levels of serum FOXA1 mRNA and TRAF6 mRNA of the pregnant women with PE are abnormal and are related to their severity of PE and their adverse pregnancy outcomes,which have value for predicting their adverse pregnancy outcomes,and the combination of the serum FOXA1 mRNA and TRAF6 mRNA levels have higher predictive value.
作者
沈敦隽
王听
黄晓林
SHEN Dunjun;WANG Ting;HUANG Xiaolin(Jiangning Hospital Affiliated to Nanjing Medical University/Nanjing Jiangning Hospital,Jiangsu Province,211100)
出处
《中国计划生育学杂志》
2022年第11期2604-2610,共7页
Chinese Journal of Family Planning
关键词
子痫前期
疾病严重程度
叉头盒蛋白A1
肿瘤坏死因子受体相关因子6
不良妊娠结局
预测
影响因素
Preeclampsia
Disease severity
Forkhead box protein A1
Tumor necrosis factor receptor-associated factor 6
Adverse pregnancy outcomes
Prediction
Influence factor
