The Value Of IL-21、IL-6、IL-16 And Umbilical Artery Blood Flow Parameters(S/D、RI、PI)in Prediction Of Preeclampsia

Objective:..Preeclampsia is a major killer,to maternal and perinatal ‘s health,its etiology is not yet clear,the prediction method is limited,to find effective prediction model is the urgent desire of many researchers.The study found that immune and inflammatory factors may be closely related to the incidence of PE.IL-21,IL-6,and IL-16 play important role in the immune and inflammatory responses,umbilical artery is thought to be important blood vessels that can reflect the function of the placenta.This study was to explore the value of IL-21,IL-6,IL-16 and umbilical artery blood flow parameters of S/D,RI,PI in predicting the the onset of preeclampsia,then find a feasible and effective prediction model.Methods:1.In this study,case-control studies were used to collect outpatient cases of the maternal and child health care hospital of jiangxi province,including 30 cases and 50 control groups according to the research criteria.2.During the initial diagnosis,took blood sampling when the pregnant week was between 16 and 20 weeks,and the serum was separated,and the content of IL-21,IL-6 and IL-16 in the two groups was determined by ELISA method.3.The blood parameters of umbilical artery(S/D,RI,PI)were determined during the screening of ultrasonic deformities in 20-24 weeks.4.All cases,follow-up to the birth,such as blood pressure,urine protein,using statistical methods to compare differences between groups,and using ROCcurve and multivariate Logistic regression to evaluate these indicators alone and combined predictive value of preeclampsia.Results:1.the serum IL-21 in control group was stastically different between the control group and the case group(p<0.05);The serum IL-16 was stastically different between the control group and the severe PE group,p<0.05;the serumIL-16 was no statistically significant difference between control group and mild group(p>0.05),.the serumIL-16 was no statistically significant difference between control group andcase group(p>0.05).2.There were stastically different of umbilical artery blood flow parameters(S/D,PI and RI)between the control group and case group(all p<0.05).3.Taking IL-21= 54.87 for predicting PE,the area under the ROC curve was0.608,the sensitivity was 0.767,and the specificity was 0.760;Taking IL-6= 3.05 for predicting PE,the area under the ROC curve was0.580,the sensitivity was 0.433,and the specificity was 0.800;Taking IL-16= 134.91 for predicting PE,the area under the ROC curve was0.786,the sensitivity was 0.600,and the specificity was 0.900.Taking umbilical artery S/D= 3.97 for predicting PE,the area under the ROC curve was0.866,the sensitivity was0.833,and the specificity was 0.720,Taking umbilical artery PI=1.28 for predicting PE,the area under the ROC curve was0.858,the sensitivity was 0.767,and the specificity was 0.900;Taking umbilical artery RI=0.98 for predicting PE,the area under the ROC curve was0.828,the sensitivity was 0.600,and the specificity was 0.800.4.Taking IL-21,IL – 6 and IL-16 combined prediction PE,the area under the ROC curve was0.871,the sensitivity was 0.900,and the specificity was 0.420;Taking S/D,RI,PI combined prediction PE,the area under the ROC curve was0.957,the sensitivity was 0.967,and the specificity was 0.860;Taking IL-21,IL – 6,IL-16 combined S/D、PI、RI prediction PE,the area under the ROC curve was0.987,the sensitivity was 0.967,and the specificity was 0.960.Conclusion:1.In the early stage of pregnancy,IL-21,IL-6 and IL-16 in the maternal serum and umbilical artery RI,S/D and PI of pre-eclampsia were elevated,2.In the early stage of pregnancy,the serum il-21,il-6,il-16,and the umbilical artery RI,S/D,and PI were increased with the severity of PE.3.These indicators were of little value when used to predict the pathogenesis of pre-eclampsia alone,we can combined with IL-21,IL-6,IL-16 and umbilical artery blood flow parameters(S/D,RI,PI)to predict preeclampsia.