| Objective:By comparing the contents of soluble endoglin（sEng）,brain natriuretic peptide（BNP）and γ-glutamyltransferase（γ-GT）in maternal peripheral blood,the differential expression of sEng,BNP and γ-GT in different degrees of preeclampsia disease and its correlation with preeclampsia disease were investigated.In order to find the sensitive biological indicators for early identification and diagnosis of the severity of preeclampsia,and provide reference for clinical diagnosis and treatment of preeclampsia disease.Methods:A total of 144 pregnant women who were hospitalized in the maternity ward of the Second Hospital of Jilin University from March 2021 to January 2022 and terminated pregnancy were selected.The control group consisted of 42 healthy pregnant women without complications,while the experimental group consisted of 32 pregnant women with preeclampsia and 70 pregnant women with severe preeclampsia.The severe preeclampsia group consisted of 35 pregnant women with early-onset severe preeclampsia（onset gestational age < 34 weeks）and 35 pregnant women with late-onset severe preeclampsia（onset gestational age ≥34 weeks）.The specific diagnostic criteria for preeclampsia and severe preeclampsia refer to guidelines for the Diagnosis and Treatment of Hypertensive Diseases in Pregnancy（2020 edition）.General clinical data was collected for all pregnant women and the pregnancy outcomes were tracked.Fasting elbow venous blood was extracted at admission,and serum sEng content of the included pregnant women was determined by enzyme-linked immunosorbent assay（ELISA）using double antibody clamp method.At the same time,various clinical biochemical indicators such as BNP andγ-GT were detected.The differences of sEng,BNP and γ-GT levels among groups and their correlation with the severity of preeclampsia disease were analyzed,and the diagnostic value of sEng,BNP and γ-GT in preeclampsia was compared by drawing receiver operating characteristic（ROC）curve.Results:1.General clinical data showed that there were significant differences in BMI before pregnancy,gestational times,systolic blood pressure,diastolic blood pressure,gestational age and neonatal weight among normal pregnancy group,preeclampsia group and severe preeclampsia group（P < 0.05）.There were significant differences in BMI before pregnancy,gestational weight gain,gestational age and neonatal weight between early-onset severe preeclampsia group and late-onset severe preeclampsia group（P < 0.05）.2.When comparing the pregnancy outcomes between the two groups,there was a significant difference in the incidence of placental abruption between the preeclampsia and severe preeclampsia groups（P < 0.05）.There were significant differences in the rate of neonates admitted to NICU,the length of hospital stay in NICU and the incidence of low birth weight infants between the two groups（P < 0.05）.There was a significant difference in the incidence of placental abruption between the early-onset severe preeclampsia group and the late-onset severe preeclampsia group（P< 0.05）.There were significant differences in the rate of neonates admitted to NICU,the length of hospital stay in NICU,low birth weight,incidence of neonatal anemia,neonatal infection and retinopathy of prematurity between the two groups（P <0.05）.3.The levels of sEng in normal pregnancy group,preeclampsia group and severe preeclampsia group were 29.88ng/m L,46.89ng/ml and 53.58ng/ml,Kruskal-Wallis H test showed that there were significant differences among the three groups（P < 0.05）.The levels of BNP in normal pregnancy group,preeclampsia group and severe preeclampsia group were 44.00pg/m L,53.00pg/ml and 115.00pg/ml,Kruskal-Wallis H test showed that there were significant differences among the three groups（P <0.05）.The levels of γ-GT in normal pregnancy group,preeclampsia group and severe preeclampsia group were 8.00U/L,11.00U/L and 15.00U/L,Kruskal-Wallis H test showed that there were significant differences among the three groups（P < 0.05）.4.The levels of sEng in the early-onset severe preeclampsia group and the late-onset severe preeclampsia group were 64.68ng/ml and 38.61ng/ml.The Mann-Whitney U test showed that there was significant difference between the two groups（P < 0.05）.The levels of BNP in early-onset severe preeclampsia group and late-onset severe preeclampsia group were 145.00 pg/ml and 110.00 pg/ml.Mann-Whitney U test showed that there was significant difference between the two groups（P < 0.05）.The levels of γ-GT in early-onset severe preeclampsia group and late-onset severe preeclampsia group were 15.00U/L and 11.00U/L.The Mann-Whitney U test showed that there was no significant difference between the two groups（P > 0.05）.5.The levels of sEng,BNP and γ-GT were positively correlated with the severity of preeclampsia.The more severe the disease,the higher sEng,BNP and γ-GT levels were（r=0.395、0.433、0.240,P < 0.05）.The correlation coefficients between sEng and BNP and γ-GT were r=0.149 and r=-0.018,while the correlation coefficients between BNP and γ-GT were r=0.039,showing no significant correlation（P > 0.05）.6.Multiple logistic regression analysis showed that BMI before pregnancy,sEng,γ-GT and albumin could be the independent influence factors for the development of preeclampsia.BMI before pregnancy,sEng and γ-GT were positively correlated with the severity of preeclampsia（OR=1.093,1.037 and 1.042）,while albumin was negatively correlated with the severity of preeclampsia（OR=0.731）.7.Receiver operating characteristic curve（ROC）analysis showed that the levels of sEng,BNP and γ-GT had certain diagnostic value for the occurrence of preeclampsia.The area of sEng under the curve was 0.855（95%CI: 0.795-0.916）,cut-off value was41.932ng/ m L,sensitivity was 66.7%,specificity was 92.9%.The area of BNP under the curve was 0.769（95%CI:0.692-0.845）,cut-off value was 101.500pg/ m L,sensitivity was 54.9%,and the specificity was 95.2%.The area of γ-GT under the curve was0.718（95%CI: 0.629-0.807）,the cut-off value was 10.500U/L,sensitivity was 61.8%and the specificity was 73.8%.The area of sEng,BNP and γ-GT combined diagnosis under the curve was 0.934（95%CI: 0.895-0.973）,sensitivity 86.3%,specificity90.5%.Conclusion:1.BMI before pregnancy,gestational weight gain,systolic blood pressure,diastolic blood pressure,gestational age and neonatal weight were related to the severity of preeclampsia.The higher BMI before pregnancy,systolic blood pressure and diastolic blood pressure were,the more severe the disease was,and the lower the gestational age and neonatal weight were.The BMI before pregnancy and gestational weight gain of early-onset severe preeclampsia group were significantly lower than those of late-onset severe preeclampsia group.2.In the group of early-onset severe preeclampsia,the pregnancy outcome was worse,the incidence of maternal placental abruption was significantly higher,the neonatal admission rate and hospitalization period were longer,and the incidence of complications such as neonatal infection,neonatal anemia and retinopathy of prematurity were higher.3.The levels of sEng,BNP and γ-GT were positively correlated with the severity of preeclampsia.The more severe the disease was,the higher sEng,BNP and γ-GT levels were.The levels of sEng and BNP were significantly higher in early-onset severe preeclampsia than those in late-onset severe preeclampsia,while the levels of γ-GT showed no significant difference between early-onset and late-onset severe preeclampsia.4.There were no significant correlations between the sEng,BNP and γ-GT in pairwise comparison,which could affect the development of preeclampsia disease alone.sEng and γ-GT are the independent risk factors for preeclampsia.5.sEng,BNP and γ-GT all have good diagnostic value for preeclampsia,and the combination of the three indicators has the highest diagnostic value,single indicator diagnostic value sEng > BNP > γ-GT. |
PDF Full Text Request