子宫螺旋动脉超声联合血清CTRP6、sTWEAK对早发型子痫前期的诊断价值

doi:10.11958/20250404

摘要/Abstract

摘要：

目的探究子宫螺旋动脉超声联合血清C1q肿瘤坏死因子相关蛋白6（CTRP6）、可溶性肿瘤坏死因子凋亡弱诱导因子（sTWEAK）对早发型子痫前期（EOPE）的诊断价值。方法选取妊娠早期至中期确诊为EOPE的孕妇104例作为EOPE组，另选取同期孕检的健康孕妇104例作为对照组。采用酶联免疫吸附试验（ELISA）测定血清CTRP6、sTWEAK表达水平；采用Logistic回归分析影响EOPE发生的因素；受试者工作特征（ROC）曲线分析血清CTRP6、sTWEAK、子宫螺旋动脉超声参数对EOPE的诊断价值。结果与对照组相比，EOPE组尿蛋白定量、收缩压、舒张压、血清CTRP6表达水平升高，sTWEAK表达水平降低，子宫螺旋动脉的搏动指数（PI）、阻力指数（RI）和收缩期峰值流速与舒张末期流速（S/D）均升高（P<0.05）。CTRP6、PI、RI、S/D、收缩压、舒张压升高是EOPE发生的危险因素，sTWEAK升高是保护因素（P<0.05）。CTRP6、sTWEAK、PI、RI、S/D五者联合诊断EOPE发生的曲线下面积最高，优于各自单独诊断（Z分别为5.924、6.583、5.664、5.399、7.627，均P<0.01）。结论子宫螺旋动脉超声联合血清CTRP6、sTWEAK对EOPE的诊断价值更高。

关键词: 子痫, 超声检查，多普勒, 细胞因子TWEAK, C1q肿瘤坏死因子相关蛋白6, 子宫螺旋动脉超声, 早发型子痫前期

Abstract:

Objective To explore the diagnostic value of uterine spiral artery ultrasound combined with serum complement C1q tumor necrosis factor related protein 6 (CTRP6) and soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) for early-onset preeclampsia (EOPE). Methods A total of 104 pregnant women diagnosed with EOPE in early to mid pregnancy were regarded as the EOPE group, and another 104 healthy pregnant women who underwent prenatal examinations were used as the control group. ELISA was applied to measure the expression levels of serum CTRP6 and sTWEAK. Logistic regression analysis was applied to analyze factors influencing the occurrence of EOPE. The diagnostic value of serum CTRP6, sTWEAK and uterine spiral artery ultrasound parameters in EOPE was analyzed by receiver operating characteristic (ROC) curve. Results Compared with the control group, proteinuria quantification, systolic blood pressure, diastolic blood pressure and serum CTRP6 were increased in the EOPE group (P<0.05), serum sTWEAK level was decreased, and pulsatile index (PI), resistance index (RI) and peak systolic velocity/end diastolic velocity (S/D) of uterine spiral artery of pregnant women were all increased in the EOPE group (P<0.05). CTRP6, PI, RI, S/D, systolic blood pressure and diastolic blood pressure were risk factors of EOPE (P<0.05), and serum level of sTWEAK was the protective factor of EOPE (P<0.05). The combination of CTRP6, sTWEAK, PI, RI and S/D had the highest AUC in the diagnosis of EOPE, which was better than their individual diagnoses (Z=5.924, 6.583, 5.664, 5.399 and 7.627, P<0.01). Conclusion The combination of uterine spiral artery ultrasound and serum CTRP6 and sTWEAK can better diagnose the occurrence of EOPE.

Key words: eclampsia, ultrasonography, Doppler, cytokine TWEAK, complement C1q tumor necrosis factor related protein 6, uterine spiral artery ultrasound, early onset preeclampsia

中图分类号:

R714.25

图/表 6

参考文献 25

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组别		年龄/岁	孕周/周		产次/次		BMI/（kg/m²）
对照组		32.47±4.31	25.94±3.52		2.20±0.51		22.18±2.24
EOPE组		32.53±4.24	25.65±3.41		2.26±0.49		22.41±2.36
t		0.097	0.600		0.973		0.752
组别	尿蛋白定量/（g/24 h）			收缩压/mmHg		舒张压/mmHg
对照组	0.23±0.05			122.42±14.87		86.15±8.41
EOPE组	0.26±0.12			136.43±16.42		92.46±9.14
t	2.850^＊＊			6.450^＊＊		5.179^＊＊

组别		年龄/岁	孕周/周		产次/次		BMI/（kg/m²）
对照组		32.47±4.31	25.94±3.52		2.20±0.51		22.18±2.24
EOPE组		32.53±4.24	25.65±3.41		2.26±0.49		22.41±2.36
t		0.097	0.600		0.973		0.752
组别	尿蛋白定量/（g/24 h）			收缩压/mmHg		舒张压/mmHg
对照组	0.23±0.05			122.42±14.87		86.15±8.41
EOPE组	0.26±0.12			136.43±16.42		92.46±9.14
t	2.850^＊＊			6.450^＊＊		5.179^＊＊

组别	CTRP6	sTWEAK
对照组	12.46±2.65	10.18±2.69
EOPE组	16.25±3.16	7.74±1.97
t	9.356^＊＊	7.435^＊＊

组别	CTRP6	sTWEAK
对照组	12.46±2.65	10.18±2.69
EOPE组	16.25±3.16	7.74±1.97
t	9.356^＊＊	7.435^＊＊

组别	PI	RI	S/D
对照组	0.56±0.05	0.37±0.05	1.64±0.13
EOPE组	0.63±0.07	0.45±0.07	1.75±0.15
t	8.720^＊＊	8.975^＊＊	5.676^＊＊