文章摘要
血清CTRP9 VASH-1对妊娠期高血压疾病患者早期肾损伤的评估价值
Evaluation value of serum CTRP9 and VASH-1 on early renal injury in patients with hypertensive disorder complicating pregnancy
投稿时间:2023-04-03  
DOI:10.3969/j.issn.1000-0399.2023.10.009
中文关键词: 补体C1q肿瘤坏死因子相关蛋白9  血管生成抑制蛋白-1  妊娠期高血压疾病  肾损伤  早期评估
英文关键词: C1q tumor necrosis factor related protein 9  Vasohibin-1  Hypertensive disorder complicating pregnancy  Renal injury  Early evaluation
基金项目:廊坊市科技支撑计划项目(编号:2022013125)
作者单位
郝媛媛 065000 河北廊坊 秦皇岛市妇幼保健院产科 
杜巍 065000 河北廊坊 秦皇岛市妇幼保健院产科 
王建美 065000 河北廊坊 秦皇岛市妇幼保健院产科 
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中文摘要:
      目的 探究血清补体C1q肿瘤坏死因子相关蛋白9 (CTRP9)、血管生成抑制蛋白-1 (VASH-1)对妊娠期高血压疾病(HDCP)患者早期肾损伤的评估价值。方法 选取2022年1~12月于河北中石油中心医院产科就诊治疗的HDCP患者112例为研究对象,根据是否发生肾损伤,将其分为非肾损伤组(n=52)和肾损伤组(n=60);另选取同期孕检正常孕妇70例作为对照组。采用酶联免疫吸附法(ELISA)检测研究对象血清CTRP9、VASH-1水平;采用Pearson分析血清CTRP9、VASH-1水平与收缩压、舒张压、肿瘤坏死因子α (TNF-α)、血尿酸、尿蛋白水平的相关性;采用多因素logistic回归分析HDCP患者发生早期肾损伤的影响因素;采用受试者工作特征(ROC)曲线分析血清CTRP9、VASH-1在早期预测HDCP患者发生肾损伤中的价值。结果 肾损伤组收缩压、舒张压、TNF-α、血尿酸、尿蛋白、VASH-1水平均高于非肾损伤组和对照组,血清CTRP9水平为(125.39±26.43) pg/mL,低于非肾损伤组和对照组,差异有统计学意义(P<0.05);患者血清CTRP9水平与收缩压、舒张压、TNF-α、血尿酸、尿蛋白水平均呈负相关(r=-0.474、-0.506、-0.487、-0.528、-0.534,P<0.05),患者血清VASH-1水平与收缩压、舒张压、TNF-α、血尿酸、尿蛋白水平均呈正相关(r=0.495、0.524、0.479、0.506、0.533,P<0.05);多因素logistic回归分析显示,高水平CTRP9是HDCP患者发生肾损伤的独立保护因素,高水平VASH-1、TNF-α、血尿酸、尿蛋白均是HDCP患者发生肾损伤的独立危险因素(P<0.05); ROC结果显示,血清CTRP9、VASH-1预测HDCP患者发生早期肾损伤的曲线下面积(AUC)分别为0.873、0.896,二者联合预测的AUC为0.955,优于各自单独预测(Z=2.319,P=0.020; Z=1.755,P=0.079),特异度为92.31%,灵敏度为86.67%。结论 发生早期肾损伤HDCP患者血清CTRP9水平降低,血清VASH-1水平升高,二者在早期预测评估HDCP患者发生肾损伤中具有一定潜在价值。
英文摘要:
      Objective To explore the value of serum C1q tumor necrosis factor-related protein 9 (CTRP9) and vasohibin-1 (VASH-1) in evaluating early renal injury in patients with hypertensive disorder complicating pregnancy (HDCP). Methods A total of 112 patients with HDCP who were treated in Obstetrics and Gynecology Department, Hebei PetroChina Central Hospital from January 2022 to December 2022 were regarded as the study subjects and grouped into non-renal injury group (52 cases) and renal injury group (60 cases) according to whether renal injury occurred; in addition, 70 normal pregnant women were regarded as the control group. Enzyme-linked immunosorbent assay (ELISA) was employed to detect the serum levels of CTRP9 and VASH-1; Pearson was applied to analyze the correlation between serum CTRP9, VASH-1 levels and systolic blood pressure, diastolic blood pressure, tumor necrosis factor-α (TNF-α), blood uric acid and urine protein levels, multivariate logistic regression was applied to analyze the influencing factors of early renal injury in HDCP patients; ROC curve was used to analyze the value of serum CTRP9 and VASH-1 in the early prediction of renal injury in patients with HDCP. Results The levels of systolic blood pressure, diastolic blood pressure, TNF-α, blood uric acid, urine protein and VASH-1 in the renal injury group were higher than those in the non-renal injury group and the control group, and the level of CTRP9 (125.39±26.43) pg/mL in serum was obviously lower than that in non-renal injury group pg/mL and control group pg/mL (P<0.05); the serum CTRP9 level of HDCP patients with early renal injury was negatively correlated with systolic blood pressure, diastolic blood pressure, TNF-α, blood uric acid and urine protein levels (r=-0.474, -0.506, -0.487, -0.528, -0.534, P<0.05), while the serum VASH-1 level was positively correlated with systolic blood pressure, diastolic blood pressure, TNF-α, blood uric acid and urine protein levels (r=0.495, 0.524, 0.479, 0.506, 0.533, P<0.05); multivariate logistic regression analysis showed that high level of CTRP9 was an independent protective factor for renal injury in HDCP patients, and high levels of VASH-1, TNF-α, serum uric acid and urine protein were independent risk factors for renal injury in HDCP patients (P<0.05); ROC results showed that the area under the curve (AUC) of serum CTRP9 and VASH-1 in predicting early renal injury in patients with HDCP was 0.873 and 0.896, respectively, the AUC predicted by the combination of the two was 0.955, which was better than that predicted separately (Z=2.319, P=0.020; Z=1.755, P=0.079), the specificity was 92.31%, and the sensitivity was 86.67%. Conclusion The level of serum CTRP9 in HDCP patients with early renal injury is obviously lower, and the level of serum VASH-1 is obviously higher, both have certain potential value in early prediction and evaluation of renal injury in HDCP patients.
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