The Expression Of Soluble Endoglin And Transthyretin In The Severe Preeclampsia

Objective:Preeclampsia is a special disease during pregnancy,its mainly performance is hypertension,proteinuria with the combination of disease and other complications after 20 weeks of gestation,is the leading cause of illness and death with pregnant women and the perinatal child.Because it has the feature of heavy onset,fast progress,poor prognosis and so on,especially tne severe preeclampsia,so to search a easier,more accurate and more effective method to predict preeclampsia for early detection,early prevention and early intervention has become the priority development direction of obstetric in recent years.With the deepening of the research,The study of a variety of clinical high-risk risk factors,biochemical markers,biophysical assessment have get a new progress.At present,a large number of experiments proved that endothelial cell activation,dysfunction and structural damage is an important part in preeclampsia pathophysiological changes,but the process of damage mechanism has not been elucidated.According to the related study,Soluble endoglin(sEng)is a kind of anti-angiogenesis protein.While Transthyretin(TTR)can form amyloid fibers deposition in the vascular system.The specifically expression with both of them in peripheral blood of pregnant women can lead to vascular endothelial dysfunction,and then cause the corresponding clinical symptoms.This study through detection the concentration of sEng and TTR in normal late pregnant women and severe preeclampsia women in peripheral blood serum level and comparison,discussing their expression in the severe preeclampsia and the value and significance of combined detection in diagnosing severe preeclampsia.Method:30 cases of severe preeclampsia patients were randomly selected in January 1 2015 to January 1 2017,they all institutional delivery during my courtyard department of gynaecology and obstetrics hospital.It would be the severe preeclampsia group,age26-39 years old,mean age(32.07�2.59)years old,gestational weeks30-37 weeks,average gestational weeks(34.18�2.23)weeks;Methods hospitalized at the same time of 30 patients without any complications and complications of healthy pregnant women during pregnancy,It would be the normal pregnancy group.age25-39 years old,mean age(31.77�3.57)years old,gestational weeks37-41 weeks,average gestational weeks(39.79�1.19)weeks.All patients were randomly selected,and their age and gestational age were balanced.Testing all the level of sEng and TTR in serum,comparison between any two means of the level of sEng and TTR in the severe preeclampsia group and normal pregnant group,and were Statistically analyzed,two indicators ' specific and sensitivity in the best diagnostic value were also measured separately and wether combined detection can add the value to the diagnosis of preeclampsia or not.Result:The sEng and TTR levels of the group were compared and analyzed statistically,and the result were compared with the results of the groups:1.The normal pregnancy group's sEng level in peripheral blood serum and the severe preeclampsia group's sEng level in peripheral blood serum compared.Through t test that P<0.05,indicating that differences compared with the results of the two group,and the fomer one is significatly reduced,the results were statistically significant.2.The normal pregnancy group's TTR level in peripheral blood serum and the severe preeclampsia group's TTR level in peripheral blood serum compared.Through t test that P=0.002 ?<0.05,indicating that differences compared with the results of the two group,and the latter one is significatly reduced,the results were statistically significant.3.Through the analysis of ROC curve,we know that:(1)The area under sEng diagnosis of severe preeclampsia was 0.794(>0.7),it shows that it has the better diagnostic efficiency,when the best diagnosis field value was 47.92pg/ml,its sensitivity was 76.67% and the specificity was 80%;(2)The area under TTR diagnosis of severe preeclampsia was 0.752(>0.7),itshows that it has the better diagnostic efficiency,when the best diagnosis fieldvalue was 91.69ug/ml,its sensitivity was 86.67% and the specificity was73.33%;(3)The area under the combined diagnosis with sEng and TTR of severe preeclampsia was 0.839(>0.7),it shows that it has the better diagnostic efficiency4.Comparison the area under ROC curve between s Eng ? TTR and combined diagnosis of severe preeclampsia,through Z tests concluded that P(AUC1)=0.604(>0.05),P(AUC2)=0.297(>0.05),P(AUC3)=0.114(>0.05),it shows there was no difference between each two comparison result,there was no statistical significance,neither sEng nor TTR and combined diagnosis can increased the detection value of severe preeclampsia.Conclusion:1.Compared the level of sEng and TTR in the normal pregnancy group and the severe preeclampsia group,the results shows that the higher the level of sEng,the lower level of TTR,the greater the risk of developing severe preeclampsia;2.sEng?TTR or combining both detection has the better diagnostic efficiency to severe preeclampsia,however,combining both detection doesn't increase the value of diagnosis.Because the study sample size is small,large sample trials are still needed for further verification.