胎盘组织和血清FGF21的表达与子痫前期发病的相关性研究-现代医学

胎盘组织和血清FGF21的表达与子痫前期发病的相关性研究

单位：1. 南京中医药大学附属南京医院妇产科, 江苏南京 210003;
2. 济南市妇幼保健院妇产科, 山东济南 250002

分类号：R714.24⁺5

出版年·卷·期（页码）：2020·39·第八期（990-994）

摘要：

目的：检测成纤维细胞生长因子21（FGF21）在正常组和子痫前期（PE）组孕妇胎盘组织和血清中的表达情况，探讨FGF21与PE的关系以及对PE的诊断价值。方法：收集2017年7月至2019年6月间在我院分娩的产妇的胎盘组织和血清，包括117例子痫前期患者和48例健康孕妇。免疫组化法检测胎盘组织中FGF21的表达；ELISA方法检测血清中FGF21的水平，采用受试者工作特征（ROC）曲线确定FGF21对PE的诊断价值。结果：FGF21蛋白在PE组孕妇胎盘组织中的阳性表达率为64.96%（76/117），明显高于健康对照组45.83%（22/48）（χ²=5.164，P<0.05）。PE患者血清中FGF21水平与血清白蛋白呈负相关性（r=-0.498，P<0.001），而与24 h尿蛋白定量呈明显的正相关性（r=0.755，P<0.001）。FGF21预测PE的ROC曲线下面积（AUC）为0.70（95% CI：0.46~0.81），截断值为18.06 ng·ml ^-1；预测重度PE的ROC曲线AUC为0.63（95% CI：0.52~0.83），截断值为26.47 ng·ml ^-1。结论：胎盘组织及外周血FGF21水平升高与子痫前期的发病存在相关性，且与子痫前期的轻、重程度有关。

Objective: To explore the expression of fibroblast growth factor 21 (FGF21) in placental tissues and sera in women with preeclampsia (PE) and its relationship with the pathogenesis of preeclampsia.Methods: Placenta tissues and venous blood samples were obtained from 117 PE women and 48 women with the normal pregnancy. Immunohistochemistry and ELISA were used to test FGF21 expression in placentas and peripheral blood. And the diagnosis values of FGF21 on PE were analyzed by receiver operating characteristic (ROC) curve.Results: The positive rate of FGF21 in PE women was 64.96% (76/117), which was higher than that in the control group[45.83% (22/48)] (χ²=5.164,P<0.05). The FGF21 level in the PE group was negatively related with albumin(r=-0.498, P=0.000), and positively related with 24-hour urine protein (r=0.755, P=0.000). The AUC of ROC curve of FGF21 on PE was 0.70 (95% CI: 0.46-0.81), and the cut-off of FGF21 on early PE was 18.06 ng·ml^-1. The AUC of FGF21 on severe PE was 0.63 (95% CI: 0.52-0.83), and the cut-off of FGF21 on severe PE was 26.47 ng·ml ^-1.Conclusion: FGF21 may be involved in the pathogenesis of preeclampsia. Furthermore, the high level of FGF21 in placenta and maternal serum would be associated with the severity of the disease.

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