文章摘要
杨华玲,谢宝国,林思婷,石敏洁,徐 尧.早发型重度子痫前期患者血清ADMA、INH-A与胎儿生长受限的关系研究[J].,2024,(10):1896-1900
早发型重度子痫前期患者血清ADMA、INH-A与胎儿生长受限的关系研究
Study on the Relationship between Serum ADMA, INH-A and Fetal Growth Restriction in Patients with Early Onset Severe Preeclampsia
投稿时间:2023-08-06  修订日期:2023-08-29
DOI:10.13241/j.cnki.pmb.2024.10.020
中文关键词: 早发型重度子痫前期  非对称性二甲基精氨酸  抑制素-A  胎儿生长受限
英文关键词: Early onset severe preeclampsia  Asymmetric dimethylarginine  Inhibin-A  Fetal growth restriction
基金项目:海南省重点研发计划项目(ZDYF2019158)
作者单位E-mail
杨华玲 海南医学院第一临床学院 海南 海口 570216 15708925250@163.com 
谢宝国 海南医学院第一附属医院生殖医学科 海南 海口 570100  
林思婷 海南医学院第一附属医院产科 海南 海口 570100  
石敏洁 海南医学院第一附属医院产科 海南 海口 570100  
徐 尧 海南医学院第一临床学院 海南 海口 570216  
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中文摘要:
      摘要 目的:探讨早发型重度子痫前期(SPE)患者血清非对称性二甲基精氨酸(ADMA)、抑制素A(INH-A)与胎儿生长受限(FGR)的关系。方法:选取2021年1月~2023年1月于海南医学院第一附属医院分娩的110例早发型SPE患者为观察组,另选取同期健康孕妇100例为对照组,根据是否合并FGR将早发型SPE患者分为FGR组46例和非FGR组64例。比较观察组与对照组血清ADMA、INH-A水平。采用多因素Logistic回归分析早发型SPE患者合并FGR的影响因素,受试者工作特征曲线(ROC)分析血清ADMA、INH-A水平对早发型SPE患者合并FGR的预测效能。结果:与对照组比较,观察组血清ADMA、INH-A水平升高(P<0.05)。与非FGR组比较,FGR组ADMA、INH-A、收缩压、舒张压、血肌酐、24 h尿蛋白定量、脐动脉血流收缩期末流速/舒张期末流速比值(S/D)水平升高,而孕前体质指数(BMI)降低(P<0.05)。多因素Logistic回归分析显示,24 h尿蛋白定量、动脉血流S/D、ADMA和INH-A升高为早发型SPE患者合并FGR的独立危险因素(P<0.05)。ROC分析显示,血清ADMA、INH-A水平联合预测早发型SPE患者合并FGR的曲线下面积大于单独预测。结论:早发型SPE患者血清ADMA、INH-A水平异常升高,且参与FGR的发生、发展,此外,血清ADMA、INH-A水平联合对早发型SPE患者合并FGR的预测效能较高。
英文摘要:
      ABSTRACT Objective: To investigate the relationship between serum asymmetric dimethylarginine (ADMA), inhibin A (INH-A) and fetal growth restriction (FGR) in patients with early onset severe preeclampsia (SPE). Methods: 110 patients with early onset SPE who were delivered in The First Affiliated Hospital of Hainan Medical University from January 2021 to January 2023 were selected as observation group, and 100 healthy pregnant women were selected as control group, patients with early onset SPE were divided into FGR group (46 cases) and no FGR group (64 cases) according to whether FGR was combined. The levels of serum ADMA and INH-A in observation group and control group were compared. The influencing factors of FGR in patients with early onset SPE were analyzed by multivariate Logistic regression analysis, the predictive effect of serum ADMA and INH-A levels on FGR in patients with early onset SPE were analyzed by receiver operating characteristic curve (ROC). Results: Compared with control group, the levels of serum ADMA and INH-A in observation group were increased (P<0.05). Compared with no FGR group, the levels of ADMA, INH-A, systolic blood pressure, diastolic blood pressure, serum creatinine, 24 h urinary protein quantification, and umbilical artery blood flow end-systolic velocity/end-diastolic velocity ratio (S/D) were increased in FGR group, while the pre-pregnancy body mass index (BMI) was decreased (P<0.05). Multivariate Logistic regression analysis showed that, 24 h urinary protein quantification, arterial blood flow S/D, ADMA and INH-A were independent risk factors for FGR in patients with early onset SPE (P<0.05). ROC analysis showed that, the area under the curve of combined prediction of serum ADMA and INH-A levels in patients with early onset SPE complicated with FGR was greater than that of single prediction. Conclusion: The levels of serum ADMA and INH-A in patients with early onset SPE are abnormally increase, and are involve in the occurrence and development of FGR, in addition, the combination of serum ADMA and INH-A levels has a high predictive efficiency for FGR in patients with early onset SPE.
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