Detection And Clinical Significance Of PTX3,C1q And NLR In Peripheral Blood Of Patients With Preeclampsia

BackgroundPreeclampsia(preeclampsia,PE)is a progressive disease that occurs specifically in human pregnancy.It affects 2-8%of pregnant women worldwide.It is one of the key causes of maternal and neonatal death during the perinatal period.It leads to more than 70,000 maternal deaths and 500,000 fetal deaths worldwide and it is the third cause of maternal deaths after postpartum hemorrhage and amniotic fluid embolism.It causes a huge social and family burden and it is the main cause of iatrogenic preterm delivery.In recent years,more and more studies have confirmed that changes in the immune system and inflammatory state play a key role in the occurrence and development of preeclampsia.The level of inflammatory indicators in the circulation may be closely related to the occurrence,development and outcome of the disease.In preeclampsia patients,the necrosis and shedding of syncytiotrophoblast cell fragments as a result of placental hypoxia increase the secretion of certain chemokines/cytokines and promote inflammation by triggering monocytes and neutrophils.Pentraxin 3(PTX3)and C1q are involved in the first line of defense of innate immunity,activating the inflammatory response pathway and regulating the immune response.In addition to participating in the inflammatory immune response process,both are also involved in the invasion of trophoblasts,vascular remodeling,tissue repairing,endothelial injury and other processes,which are closely related to the occurrence and development of preeclampsia.NLR,the neutrophil-to-lymphocyte ratio,is an important indicator reflecting the degree of immune response and systemic inflammation.PurposesBy comparing the differences in serum PTX3,complement C1q levels and NLR between preeclampsia patients and the control group,the research aim to explore the relationship between these biomarkers and the clinical characteristics of preeclampsia patients and pregnancy outcome.Besides,evaluation the value of three biomarkers for diagnosis and pregnancy outcomes of preeclampsia provides a more reliable basis for clinical diagnosis and determination of the timing of pregnancy termination.MethodsA collection of 76 patients who were hospitalized in the obstetric ward of Shandong Provincial Hospital from May 2020 to December 2020 includes 46 pregnant women without comorbidities as the control group and 30 patients with preeclampsia as the case group,14 of which belong to the mid preeclampsia group(MPE group),16 cases belong to the severe preeclampsia group(SPE group).Enzyme-linked immunosorbent assay was used to test the concentration of PTX3 in the included subjects,and the complement C1q,NLR and other clinical indicators were detected at the same time.Analyze the differences in the levels of PTX3,complement C1q,and NLR between the groups and explore their correlation with the severity of preeclampsia and pregnancy outcomes.Results1.Compared with the control group,PTX3 and NLR in the case group increase significantly,and there is a significant difference between the two groups(P value<0.05).While the complement C1q is significantly reduced,and the difference is also statistically significant(P<0.001).2.In the case group,the PTX3 and NLR of the SPE group are significantly higher than those of the MPE group,and the differences are statistically significant(P value<0.05);there is no significant difference in complement Clq between the SPE group and the MPE group,P value>0.05.3.Serum PTX3 level is negatively correlated with fetal birth weight(r value=-0.564,P value<0.001),APGAR score(r value=-0.531,P value<0.001)and the termination week(r value=-0.4495,P value<0.001).4.Complement C1q level is positively correlated with the fetal birth weight(r value=0.4045,P value<0.001),APGAR score(r value=0.47,P value<0.001)and termination week(r value=0.508,P value<0.001)respectively.5.NLR is not correlated with fetal birth weight(r value=-0.2443,P value<0.05),APGAR score(r value=-0.2955,P value<0.05)and termination week(r value=-0.3388,P value<0.05)respectively.6.PTX3 ROC curve shows:AUC=0.917,95%CI:0.854-0.979,P<0.0001,cut-off value:2.28 ng/L,sensitivity 82.76%,specificity 81.40%,Youden index 0.688;Clq ROC curve shows:AUC=0.790,95%CI:0.681-0.899,P<0.0001,cut-off value:183 mg/L,sensitivity 80.00%,specificity 73.91%,Youden index 0.539;NLR ROC curve shows:AUC=0.637,95%CI:0.506-0.769,P<0.05,cut-off value:4.09,sensitivity 50.00%,specificity 80.43%,Youden index 0.304.Conclusions1.PTX3,C1q can be used for the diagnosis of preeclampsia.The diagnostic value of PTX3 is obviously better than that of C1q;2.PTX3 and NLR are positively correlated with the severity of preeclampsia.In patients with severe preeclampsia,PTX3 and NLR are significantly increased;C1q has no correlation with the severity of the disease.3.There is a correlation between PTX3 and fetal birth weight and APGAR score and the termination weeks;and there is a correlation between Clq and fetal birth weight and APGAR score and the termination weeks;while NLR has no correlation with the termination week,fetal birth weight and APGAR score.