趋化因子17与早发型重度子痫前期不良结局的相关性

目的测定早发型重度子痫前期孕产妇血清胸腺活化调节趋化因子17(thymus and activation-regulated chemokine/CC chemokine ligand 17,CCL 17)浓度,分析CCL 17浓度与孕产妇不良结局的相关性。方法回顾性分析2015年2月至2019年4月乌鲁木齐市第一人民医院确诊的早发型重度子痫前期167例孕产妇(患病组)临床资料,根据1∶1的样本量选取方法选择本院完成分娩的健康孕产妇167例作为健康对照组,检测并比较两组血清CCL 17浓度。再根据早发型重度子痫前期孕产妇是否发生不良结局分为不良结局组与结局良好组,比较两组孕20~27周(T 1)、28~34周(T 2)血清CCL 17浓度,分析CCL 17浓度与早发型重度子痫前期孕产妇不良结局的关系。结果健康对照组孕期各时点血清CCL 17浓度高于患病组(P<0.05);患病组167例孕产妇发生不良结局52例(31.14%);不良结局组孕期各时点血清CCL 17浓度均低于结局良好组(P<0.05);Logistic回归分析结果显示,各时点血清CCL 17浓度低表达可能是早发型重度子痫前期不良结局的影响因素(OR>1,P<0.05);绘制受试者工作曲线结果显示,T 1、T 2各时点血清CCL 17浓度预测早发型重度子痫前期孕产妇不良结局的曲线下面积分别为0.943、0.927,预测价值高,且以T 1时点预测特异度、敏感度最理想。结论血清CCL 17浓度的异常变化可能是预测早发型重度子痫前期孕产妇母婴不良结局的指标,二者之间存在密切联系,在早发型重度子痫前期孕产妇中,一旦发现趋化因子CCL 17表达异常,应高度警惕母婴不良结局,及时采取措施,减少不良结局的发生。

The correlation between chemokine CCL 17 and adverse outcome of early-onset severe preeclampsia

Objective To measure the concentration of serum thymus and activation-regulated chemokine/CC chemokine ligand 17(CCL 17)in pregnant women with early-onset severe preeclampsia,and to analyze the correlation between CCL 17 concentration and adverse pregnancy outcome.Methods The clinical data of 167 pregnant women with early-onset severe preeclampsia(the diseased group)who were confirmed in Urumqi First People’s Hospital from February 2015 to April 2019 were retrospectively analyzed.167 healthy pregnant women who completed the delivery in our hospital were selected as the healthy control group according to the selection method of 1∶1 sample size.The concentration of serum CCL 17 in the two groups was detected and compared.According to whether early-onset severe preeclampsia pregnant women had adverse outcomes,they were divided into adverse outcome groups and good outcome groups.The serum CCL 17 concentration was compared between the two groups at 20~27 weeks(T1)and 28~34 weeks(T2),and the relationship between CCL 17 concentration and early maternal severe preeclampsia adverse maternal outcome was analyzed.Results The serum CCL 17 concentration in the healthy control group at each time during pregnancy were higher than those in the diseased group(P<0.05).A total of 52 cases(31.14%)of adverse outcome were detected in 167 pregnant women of the diseased group.The serum CCL 17 concentration in the adverse outcome group at each time during pregnancy were lower than those in the good outcome group(P<0.05).The results of Logistic regression analysis showed that the low expression of serum CCL 17 concentration at each time may be the influencing factors for adverse outcome in pregnant women with early-onset severe preeclampsia(OR>1,P<0.05).The area under the curve(AUC)obtained by drawing the receiver operating characteristic curve showed that the AUC of serum CCL 17 at T1,T2 in predicting adverse outcome of pregnant women with early-onset severe preeclampsia was 0.943 and 0.927,and the predictive value was high,and the specificity and sensitivity at T1 were the ideal.Conclusion The abnormal changes of serum chemokine CCL 17 concentration may be the indicator for predicting the adverse outcome of early-onset severe preeclampsia,and there is close relationship between the two.In pregnant women with early-onset severe preeclampsia,once the abnormal expression of chemokine CCL 17 is found,it is important to be vigilant against adverse outcomes of mothers and infants,and timely measures can be taken to reduce the adverse outcome,which is of great significance for ensuring the safety of mothers and infants.