| 早发型子痫前期患者血清ESM1 及LRP1 表达水平及其与病情严重程度的相关性研究 |
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| 引用本文： | 彭 勃,李永平,刘海燕,朱晓红.早发型子痫前期患者血清ESM1 及LRP1 表达水平及其与病情严重程度的相关性研究[J].现代检验医学杂志,2023,0(3):184-188. |
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| 作者姓名： | 彭 勃 李永平 刘海燕 朱晓红 |
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| 作者单位： | （1. 江苏省盐城市妇幼保健院产科，江苏盐城 224000；2. 江苏省盐城市滨海县中医院产科，江苏滨海 224599） |
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| 摘 要： | 目的 探讨早发型子痫前期(early onset pre-eclampsia, EOSP) 患者血清内皮细胞特异性分子-1（endothelial cellspecific molecule-1，ESM1）及低密度脂蛋白受体相关蛋白-1(low-density lipoprotein receptor-related protein-1，LRP1) 水平及与病情严重程度的相关性。方法 选取2019 年2 月～ 2021 年2 月盐城市妇幼保健院218 例早发型子痫前期患者为研究对象（病例组），根据病情分为轻度组（n=117）和重度组（n=101），以同期健康体检的80 例健康孕妇为对照组。比较各组血清ESM1 和LRP1 水平。采用多因素Logistic 回归分析早发型子痫前期病情严重程度的影响因素。绘制受试者工作曲线分析血清ESM1 和LRP1 对早发型重度子痫前期的诊断价值。结果 病例组血清ESM1(323.05±45.17 mmol/L)，LRP1(12.25±0.97 μg/ml) 水平高于对照组（195.20±31.67 mmol/L，6.41±0.84 μg/ml），差异具有统计学意义（t=23.291，47.677，均P<0.05）。重度组患者血清ESM1(672.44±83.61 pg/ml)，血清LRP1(14.52±1.05 μg/ml)、舒张压（113.17±12.24mmHg）、收缩压（165.19±16.63mmHg）、24h 尿蛋白量（2.63±0.45g/24h）、血肌酐（74.47±20.82μmol/L）、血尿素氮（4.32±0.78mmol/L）、血尿酸（339.65±50.13μmol/L）高于轻度组（551.74±72.20 pg/ml，9.63±0.89 μg/ml，92.41±9.29 mmHg，147.25±14.66mmHg，1.42±0.33g/24h，69.64±15.07μmol/L，3.95±0.91mmol/L，303.82±41.71μmol/L），新生儿体质量低于轻度组（2.73±0.62 kg vs 3.20±0.62 kg），差异具有统计学意义（t=1.980 ～37.978，均P<0.05）。病例组患者血清ESM1 及LRP1 水平与舒张压、收缩压、24h 尿蛋白定量、血肌酐、血尿素氮及血尿酸呈正相关(r=0.413 ～ 0.515，均P <0.05)，与胎儿体质量呈负相关(r=-0.563, -0.604，均P <0.05)。高血清ESM1水平（OR=1.217，95%CI:1.036 ～ 1.429）和高血清LRP1 水平（OR=1.486，95%CI:1.056 ～ 2.090）是影响早发型重度子痫前期发生的独立危险因素。血清ESM1 联合LRP1 诊断早发型重度子痫前期的曲线下面积（area under the curve,AUC）0.884(0.853 ～ 0.916) 大于ESM1（AUC=0.749，95%CI :0.705 ～ 0.792) 和LRP1（AUC=0.760，95%CI:0.712 ～ 0.807)单独诊断(Z=6.752，4.297，均P <0.05)。结论 早发型子痫前期患者血清ESM1 和LRP1 水平升高，二者均与早发型子痫前期疾病严重程度有关，联合检测能提高早发型重度子痫前期的诊断效能。
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| 关 键 词： | 早发型重度子痫前期 内皮细胞特异性分子-1 低密度脂蛋白受体相关蛋白-1 |
Study on the Expression Levels of Serum ESM1 and LRP1 in Patients with Early Onset Preeclampsia and Their Correlation with the Severity of the Disease |
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| PENG Bo,LI Yong-ping,LIU Hai-yan,ZHU Xiao-hong.Study on the Expression Levels of Serum ESM1 and LRP1 in Patients with Early Onset Preeclampsia and Their Correlation with the Severity of the Disease[J].Journal of Modern Laboratory Medicine,2023,0(3):184-188. |
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| Authors: | PENG Bo LI Yong-ping LIU Hai-yan ZHU Xiao-hong |
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| Affiliation: | （1. Department of Obstetrics, Jiangsu Yancheng Maternal and Child Health Care Hospital，Jiangsu Yancheng 224000,China; 2. Department of Obstetrics, Yancheng Binhai County Hospital of Traditional Chinese Medicine, Jiangsu Binhai 224599,China） |
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| Abstract: | Objective To investigate the correlation between the level of serum endothelial cell specific molecule-1 (ESM1) and low-density lipoprotein receptor related protein-1 (LRP1) and the severity of early onset preeclampsia(EOSP). Methods 218 cases of early onset preeclampsia in Yancheng Maternal and Child Health Care Hospital from February 2019 to February 2021 were selected as the study subjects (case group), and were divided into mild group (n=117) and severe group (n=101) according to the condition of the disease,80 healthy pregnant women in the same period were taken as the control group. Serum ESM1 and LRP1 levels were compared in each group. Multivariate logistic regression was used to analyze the influencing factors of the severity of EOPS. The working curve of subjects was drawn to analyze the diagnostic value of serum ESM1 and LRP1 in early onset severe preeclampsia. Results Serum ESM1 (323.05 ± 45.17 mmol/L) and LRP1 (12.25 ± 0.97 μ g/ml) in case group was higher than that in the control group（195.20±31.67 mmol/L，6.41±0.84 μg/ml）, and the differences were statistically significant (t=23.291, 47.677, all P<0.05). Serum ESM1 (672.44 ± 83.61 pg/ml), serum LRP1 (14.52 ± 1.05 μ g/ml), diastolic blood pressure（113.17±12.24mmHg）, systolic blood pressure（165.19±16.63mmHg）, 24h urine protein volume（2.63±0.45g/24h）, blood creatinine（74.47±20.82μmol/L）, lood urea nitrogen（4.32±0.78mmol/L） and blood uric acid （339.65±50.13μmol/L）in the severe group were higher than those in the mild group（551.74±72.20 pg/ml, 9.63±0.89 μg/ml, 92.41±9.29 mmHg, 147.25±14.66mmHg, 1.42±0.33g/24h, 69.64±15.07μmol/L, 3.95±0.91mmol/L, 303.82±41.71μmol/L）, while neonatal body mass was lower than that in the mild group（2.73±0.62 kg vs 3.20±0.62 kg）, the differences were statistically significant(t=1.980 ～ 37.978, all P<0.05). Serum ESM1 and LRP1 levels in case group patients were positively correlated with diastolic blood pressure, systolic blood pressure, 24h urine protein quantity, serum creatinine, blood urea nitrogen and blood uric acid (r=0.413 ～ 0.515, all P<0.05), and negatively correlated with fetal body mass (r=-0.563, -0.604，all P<0.05). High serum ESM1 level (OR=1.217, 95% CI: 1.036 ～ 1.429) and high serum LRP1 level (OR=1.486, 95% CI: 1.056 ～ 2.090) were independent risk factors affecting the occurrence of early onset severe preeclampsia. The area under the curve(AUC) of serum ESM1 combined with LRP1 in diagnosing early onset severe preeclampsia was 0.884 (0.853 ～ 0.916)， which was larger than ESM1(AUC=0.749,95%CI: 0.705 ～ 0.792) and LRP1(AUC=0.760,95%CI: 0.712 ～ 0.807) diagnosed alone(Z=6.752，4.297，all P<0.05). Conclusion Serum ESM1 and LRP1 levels in patients with EOSP were elevated, both of which were related to the severity of EOSP，combined detection can improve the diagnostic efficacy of early onset severe preeclampsia. |
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