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血清sST-2、BNP和PAPP-A在妊娠高血压合并心力衰竭中预测妊娠不良结局的临床价值

  

  1. 复旦大学附属妇产科医院 产科,上海 200090
  • 出版日期:2020-02-20 发布日期:2020-03-24
  • 通讯作者: 蔡慧丽, Email: caihuili2019@163.com

Clinical value of serum sST2,  BNP and PAPPA in predicting adverse pregnancy outcomes in pregnancyinduced hypertension patients with heart failure

  1. Department of Obstetrics,  Obstetrics and Gynecology Hospital affiliated to Fudan University,  Shanghai 200090, China
  • Online:2020-02-20 Published:2020-03-24
  • Contact: Corresponding author: Cai Huili, Email: caihuili2019@163.com

摘要: 目的  观察血清可溶性生长刺激表达因子2(sST2)、脑钠肽(BNP)和妊娠相关血浆蛋白A(PAPPA)在妊娠高血压合并心力衰竭(心衰)中预测妊娠不良结局的临床价值。方法  选择在我院诊治的妊娠高血压合并心力衰竭的患者126例,为妊高症合并心力衰竭组。选择同期在我院就诊妊娠高血压患者和妊娠体检者,分别为妊娠高血压组(45例)和正常妊娠组(45例)。血清sST2、BNP和PAPPA水平检测采用酶联免疫吸附试验。观察各组血清sST2、BNP和PAPPA水平的变化,妊高症合并心衰组患者血清sST2、BNP和PAPPA水平与妊娠高血压严重程度、心力衰竭分级和不良妊娠结局的关系及其在预测不良妊娠结局的诊断效能。结果  妊高症合并心衰组血清sST2、BNP和PAPPA水平明显高于妊娠高血压组和正常妊娠组(P<0.01),而妊娠高血压组明显高于正常妊娠组(P<0.01)。妊高症合并心衰患者血清sST2、BNP和PAPPA水平随着妊娠高血压严重程度和心功能分级的升高而升高(P<0.01)。妊高症合并心衰患者血清sST2、BNP和PAPPA水平不良妊娠结局组明显高于良好妊娠结局组(P<0.01)。结论  血清sST2、BNP和PAPPA水平与妊娠高血压合并心衰病情严重程度有关,在预测不良妊娠结局方面具有较高的预测效能,具有重要的临床价值。

关键词: 高血压,  , 妊娠性, 胞间信号肽类和蛋白质类, 利钠肽,  , 脑, 心力衰竭,  , 充血性, 妊娠结局

Abstract: Objective  To observe the clinical value of serum soluble growth stimulating factor2 (sST2),  brain natriuretic peptide (BNP),  and pregnancyassociated plasma proteinA (PAPPA) in predicting adverse pregnancy outcomes in pregnancyinduced hypertension(PIH) patients with heart failure(HF). Methods  Totally 126 PIH patients with HF in our hospital were selected as PIH&HF group. PIH patients and people having pregnancy test in our hospital during the same period were selected as PIH  group (45 cases) and normal pregnancy group (45 cases),  respectively. The serum sST2,  BNP and PAPPA levels in each group were measured by enzymelinked immunosorbent assay(ELISA). The changes of serum sST2,  BNP and PAPPA levels were observed in each group,  and  their relationship with  PIH severity, HF classification,  and adverse pregnancy outcomes in patients of PIH&HF group was also analyzed,  as well astheir diagnostic efficacy in predicting adverse pregnancy outcomes. Results  The serum levels of sST2,  BNP and PAPPA in PIH&HF group were significantly higher than those in PIH group and normal pregnancy group (P<0.01),  while the levels in PIH group were significantly higher than those in normal pregnancy group (P<0.01).The serum sST2,  BNP and PAPPA levels in PIH&HF group increased as the rise of PIH  severity and cardiac function (P<0.01). The serum sST2,  BNP,  and PAPPA levels in PIH&HF group were significantly higher in adverse pregnancy outcomes group than those in good pregnancy outcomes group (P<0.01). Conclusion  The serum sST2,  BNP and PAPPA levels are related to the severity of PIH with HF,  and have high efficacy and important clinical value in predicting adverse pregnancy outcomes.

Key words: hypertension, pregnancyinduced, intercellular signaling peptides and proteins, natriuretic peptide, brain, pregnancyassociated plasma proteinA, pregnancyinduced hypertension, heart failure, congestive; , pregnancy outcome