| 陈丽丽,高会影,赵艳玲.子痫前期病人血清 Trop-2、TBX5水平及其预测不良妊娠结局价值[J].安徽医药,2025,29(6):1226-1230. |
| 子痫前期病人血清 Trop-2、TBX5水平及其预测不良妊娠结局价值 |
| Levels of serum Trop-2 and TBX5 in patients with preeclampsia and their predictive value for adverse pregnancy outcomes |
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| DOI：10.3969/j.issn.1009-6469.2025.06.033 |
| 中文关键词: 先兆子痫 人滋养细胞表面抗原 T-框蛋白 5 妊娠结局 预测 |
| 英文关键词: Pre-eclampsia Human trophoblast cell surface antigen |
| 基金项目:保定市科技计划项目( 1951ZF036) |
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| 摘要点击次数: 70 |
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| 中文摘要: |
| 目的检测子痫前期病人血清人滋养细胞表面抗原(Trop-2)、T-框蛋白 5(TBX5)水平，并分析其预测不良妊娠结局的价值。方法选择 2020年 10月至 2023年 9月在保定市第二中心医院产检并分娩的 196例子痫前期孕妇以及 196例健康孕妇分别作为子痫组和对照组，根据不同妊娠结局将 196例子痫前期孕妇分为不良结局组和良好结局组；利用 BK-400型全自动生化分析仪检测甘油三酯( TG)、总胆固醇( TC)、空腹血糖( FBG)、高密度脂蛋白胆固醇( HDL-C)水平；采用自动脉搏波血压仪检测收缩压和舒张压；采用韩国赛宝 Cybow720型尿液分析仪测定尿蛋白浓度，并根据总尿量计算 24 h尿蛋白量；采用酶联免疫吸附试验(ELISA)检测血清 Trop-2、TBX5水平；采用多因素 logistic回归分析影响子痫前期孕妇不同妊娠结局的因素；采用受试者操作特征曲线( ROC曲线)分析血清 Trop-2、TBX5水平对子痫前期孕妇不同妊娠结局的预测价值，采用 Z检验比较 ROC曲线曲线下面积( AUC)。结果子痫组血清 TBX5水平［( 20.86±6.45)μg/L比( 15.34±5.07)μg/L］以及舒张压、 FBG、24 h尿蛋白、 TG、收缩压、 TC显著高于对照组， Trop-2水平［( 5.46±1.72)μg/L比( 7.37±2.08)μg/L］以及 HDL-C显著低于对照组( P<0.05)；子痫组早产儿、胎儿窘迫、胎盘早剥等以及不良妊娠结局总发生率较对照组明显升高( P<0.05)；不良结局组血清 TBX5水平［(23.01±6.66)μg/L比( 19.53±6.32)μg/L］以及舒张压、 FBG、24 h尿蛋白、 TG、收缩压、 TC较良好结局组显著升高， Trop-2水平［( 4.90±1.61)μg/L比( 5.81±1.79)μg/L］以及 HDL-C显著下降( P<0.05)； Trop-2［OR 95%CI:0.38(0.28，0.53)］、 TBX5［OR 95%CI:3.89(1.88，8.04)］以及 24 h尿蛋白［ OR 95%CI:3.14(1.82，5.42)］是子痫前期孕妇妊娠结局的影响因素( P<0.05)；血清 Trop-2、TBX5以及二者联合预测子痫前期孕妇妊娠结局的 AUC分别为 0.79、0.76、0.90，二者联合预测较 Trop-2、TBX5单一预测价值更高(均 P<0.05)。结论子痫前期孕妇血清 Trop-2水平异常降低， TBX5水平异常升高，二者联合可作为评价不良妊娠结局的生物学指标。 |
| 英文摘要: |
| Objective To detect the serum levels of human trophoblast cell surface antigen (Trop-2) and T-box protein 5 (TBX5) in patients with preeclampsia and analyze their predictive value for adverse pregnancy outcomes. Methods A total of 196 preeclampsiacases and 196 healthy pregnant women who underwent prenatal examination and delivery at Baoding Second Central Hospital from Oc-tober 2020 to September 2023 were selected as the preeclampsia group and control group, respectively. The 196 preeclampsia caseswere divided into an adverse outcome group and a good outcome group based on pregnancy outcomes. The levels of triglyceride (TG), to-tal cholesterol (TC), fasting blood glucose (FBG) and high-density lipoprotein cholesterol (HDL-C) were measured using a BK-400 auto-matic biochemical analyzer. Systolic and diastolic blood pressure were measured using an automatic pulse wave blood pressure monitor.Urinary protein concentration was determined using a Cybow720 urine analyzer, and 24-hours urinary protein was calculated based on total urine volume. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum Trop-2 and TBX5 levels. Multivariate logis-tic regression was applied to identify factors influencing pregnancy outcomes in preeclampsia. Receiver operating characteristic (ROC)curve analysis was used to evaluate the predictive value of serum Trop-2 and TBX5 levels for pregnancy outcomes in preeclampsia, and Z-tests were used to compare the areas under the ROC curves (AUCs). Results The serum TBX5 level [(20.86 ± 6.45) μg/L vs. (15.34 ± 5.07) μg/L], diastolic blood pressure, FBG, 24-hour urinary protein, TG, systolic blood pressure and TC were significantly higher in the preeclampsia group than in the control group, while Trop-2 levels [(5.46 ± 1.72) μg/L vs. (7.37 ± 2.08) μg/L] and HDL-C were sig-nificantly lower (P<0.05). The preeclampsia group had significantly higher rates of preterm birth, fetal distress, placental abruption,and overall adverse pregnancy outcomes than the control group (P<0.05). The adverse outcome group had significantly higher serum TBX5 levels [(23.01 ± 6.66) μg/L vs. (19.53 ± 6.32) μg/L], diastolic blood pressure, FBG, 24-hour urinary protein, TG, systolic blood pressure, and TC compared to the good outcome group, while Trop-2 levels [(4.90 ± 1.61) μg/L vs. (5.81 ± 1.79) μg/L] and HDL-C were significantly lower (P<0.05). Trop-2[OR 95%CI: 0.38 (0.28, 0.53)], TBX5 [OR 95%CI: 3.89 (1.88, 8.04)], and 24-hour urinary protein [OR 95%CI: 3.14 (1.82, 5.42)] were identified as influencing factors for pregnancy outcomes in preeclampsia (P<0.05). The AUCs for serum Trop-2, TBX5, and their combination in predicting pregnancy outcomes in preeclampsia were 0.79, 0.76, and 0.90, respectively,indicating that the combined prediction of the two markers had higher predictive value than either Trop-2 or TBX5 alone (both P<0.05). Conclusions In preeclampsia, serum Trop-2 levels are abnormally low, while TBX5 levels are abnormally high. The combination ofthese two markers can serve as a biological indicator for evaluating adverse pregnancy outcomes. |
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