目的: 探讨血清成纤维生长因子（fibroblast growth factor,FGF）23、热休克蛋白（heat shock protein,HSP）70、解整合素金属蛋白酶10（a disintegrin and metalloproteinase 10,ADAM10）联合预测单胎子痫前期不良结局的临床价值。方法: 纳入2023年1月1—2023年12月的单胎子痫前期患者150例归为子痫组,将同期来院健康体检单胎孕妇72例归为参照组,根据子痫组妊娠结局分为良好组（n=103）与不良组（n=47）。ELISA检测FGF23、HSP70、ADAM10水平。Pearson分析FGF23、HSP70、ADAM10与发生子痫的相关性。多因素Logistic回归分析影响子痫后不良妊娠结局发生的因素,ROC分析FGF23、HSP70、ADAM10联合对单胎子痫前期的发生及出现不良妊娠结局的预测价值。结果: 子痫组血压、FGF23、HSP70、ADAM10水平高于参照组;FGF23、HSP70、ADAM10联合诊断子痫前期发生的AUC为0.840,优于单独诊断（0.746、0.731、0.7790,P<0.05）;不良组FGF23、HSP70、ADAM10高于良好组;FGF23、HSP70、ADAM10与子痫前期发生呈正相关（r=0.375、0.577、0.342,P<0.001）;FGF23、HSP70、ADAM10为子痫前期患者发生不良妊娠结局的危险因素;FGF23、HSP70、ADAM10诊断子痫前期患者发生不良妊娠结局的AUC为0.812,优于单独诊断（0.736、0.704、0.744,P<0.05）。结论: FGF23、HSP70、ADAM10与子痫前期患者继发不良妊娠结局密切相关,联合检测子痫前期的发生及继发不良妊娠结局均具有一定的预测价值,监测FGF23、HSP70、ADAM10水平变化对改善患者不良结局意义重大。
Abstract
Objective To explore the clinical value of combined detection of serum fibroblast growth factor 23 (FGF23) , heat shock protein 70 (HSP70) , and a disintegrin and metalloproteinase 10 (ADAM10) in predicting adverse outcomes of singleton preeclampsia. Methods A total of 150 singleton preeclampsia patients from January to December 2023 were included as the preeclampsia group. Meanwhile, 72 singleton pregnant women who came to the hospital for a healthy physical examination during the same period were included as the reference group. According to the pregnancy outcomes of the preeclampsia group, they were divided into the favorable outcome group (n=103) and the adverse outcome group (n=47) . The levels of FGF23, HSP70, and ADAM10 were detected by ELISA. Pearson correlation analysis was performed to analyze the correlations between FGF23, HSP70, and ADAM10 and the occurrence of preeclampsia. Multivariate logistic regression analysis was used to analyze the influencing factors for the occurrence of adverse pregnancy outcomes after preeclampsia. ROC curve analysis was used to analyze the predictive value of the combination of FGF23, HSP70, and ADAM10 for the occurrence of singleton preeclampsia and the occurrence of adverse pregnancy outcomes. Results The blood pressure and the levels of FGF23, HSP70, and ADAM10 in the preeclampsia group were higher than those in the reference group. The area under the curve (AUC) of the combined diagnosis of FGF23, HSP70, and ADAM10 for the occurrence of preeclampsia was 0.840, which was better than that of individual diagnoses (0.746, 0.731, 0.7790; P<0.05) . The levels of FGF23, HSP70, and ADAM10 in the adverse outcome group were higher than those in the favorable outcome group. FGF23, HSP70, and ADAM10 were positively correlated with the occurrence of preeclampsia (r=0.375, 0.577, 0.342; P<0.001). FGF23, HSP70, and ADAM10 were risk factors for adverse pregnancy outcomes in preeclampsia patients. The AUC of the diagnosis of adverse pregnancy outcomes in preeclampsia patients by FGF23, HSP70, and ADAM10 was 0.812, which was better than that of individual diagnoses (0.736, 0.704, 0.744; P<0.05). Conclusion FGF23, HSP70, and ADAM10 are closely related to secondary adverse pregnancy outcomes in preeclampsia patients. The combined detection has certain predictive values for the occurrence of preeclampsia and secondary adverse pregnancy outcomes. Monitoring the changes in the levels of FGF23, HSP70, and ADAM10 is of great significance for improving the adverse outcomes of patients.
关键词
成纤维生长因子23 /
热休克蛋白70 /
解整合素金属蛋白酶10 /
子痫前期 /
不良结局
Key words
fibroblast growth factor 23 /
heat shock protein 70 /
disintegrin metalloproteinase 10 /
preeclampsia /
adverse outcomes
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基金
黑龙江省教育厅科学技术研究项目“血清FGF23、HSP70、ADAM10联合检测对单胎子痫前期不良结局的预测价值研究”（22031682）
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