摘要
目的探讨血清胰岛素样生长因子结合蛋白3(IGFBP-3)、磷脂转运蛋白(PLTP)和脂肪细胞型脂肪酸结合蛋白(AFABP)对妊娠期肝内胆汁淤积症(ICP)患者不良妊娠结局的预测价值。方法选择2019年1月至2021年6月在该院住院的108例ICP患者为ICP组,另选择该院同期75例体检健康孕妇为对照组。检测所有孕妇的肝功能及血清IGFBP-3、PLTP、AFABP水平,并根据总胆红素(TBIL)和总胆汁酸将ICP的严重程度分为轻、中、重度。比较ICP组和对照组的肝功能及血清IGFBP-3、PLTP、AFABP水平的变化,分析血清IGFBP-3、PLTP和AFABP水平与ICP严重程度、妊娠结局的关系。采用受试者工作特征曲线分析IGFBP-3、PLTP、AFABP对不良妊娠结局的预测效能,采用Pearson相关分析IGFBP-3、PLTP、AFABP间的相关性。结果ICP组血清天门冬氨酸氨基转移酶、丙氨酸氨基转移酶、TBIL、直接胆红素、PLTP和AFABP水平明显高于对照组(P<0.05),而IGFBP-3水平明显低于对照组(P<0.05)。血清IGFBP-3水平随着ICP严重程度升高而降低(P<0.05),而血清PLTP和AFABP水平随着ICP严重程度升高而升高(P<0.05)。ICP患者妊娠结局不良组血清IGFBP-3水平明显低于良好组(P<0.05),而血清PLTP和AFABP水平明显高于良好组(P<0.05)。血清IGFBP-3、PLTP、AFABP联合检测预测ICP患者不良妊娠结局的曲线下面积(AUC)为0.947,高于IGFBP-3、PLTP、AFABP单独检测的AUC(Z=2.705、3.193、2.336,P<0.05)。ICP患者血清IGFBP-3水平与PLTP、AFABP呈负相关(r=-0.623、-0.713,P<0.05),PLTP水平与AFABP呈正相关(r=0.658,P<0.05)。结论IGFBP-3、PLTP和AFABP参与了ICP的发生、发展过程,与ICP患者不良妊娠结局有关,这3项指标联合检测可提高预测不良妊娠结局的效能。
Objective To investigate the predictive value of serum insulin-like growth factor binding protein-3(IGFBP-3),phospholipid transporter(PLTP)and adipocyte fatty acid-binding protein(AFABP)in adverse pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy(ICP).Methods A total of 108 ICP patients who were hospitalized in this hospital from January 2019 to June 2021 were selected as the ICP group,and 75 healthy pregnant women who had undergone physical examination in the hospital during the same period were selected as the control group.The liver function and the serum levels of IGFBP-3,PLTP and AFABP were detected in all pregnant women,and the severity of ICP was divided into mild,moderate and severe according to total bilirubin(TBIL)and total bile acid.Receiver operating characteristic curve was used to analyze the predictive power of IGFBP-3,PLTP and AFABP for adverse pregnancy outcomes,and Pearson correlation was used to analyze the correlation among IGFBP-3,PLTP and AFABP.Results The serum levels of aspartate aminotransferase,alanine aminotransferase,TBIL,direct bilirubin,PLTP and AFABP in the ICP group were significantly higher than those in the control group(P<0.05),while the level of IGFBP-3 in the ICP group was significantly lower than that in the control group(P<0.05).The serum level of IGFBP-3 decreased with increase of ICP severity(P<0.05),while the serum levels of PLTP and AFABP increased with the increase of ICP severity(P<0.05).The serum level of IGFBP-3 in the poor pregnancy outcome group of ICP patients was significantly lower than that in the good group(P<0.05),while the serum levels of PLTP and AFABP were significantly higher than those in the good group(P<0.05).The area under the curve(AUC)of combined detection of serum IGFBP-3,PLTP and AFABP for predicting adverse pregnancy outcome in ICP patients was 0.947,which was higher than the AUC of IGFBP-3,PLTP and AFABP alone(Z=2.705,3.193,2.336,P<0.05).The serum level of IGFBP-3 in ICP patients was negatively correlated with PLTP and AF
作者
钟萍娇
曹晓晓
王丽
周栋雯
ZHONG Pingjiao;CAO Xiaoxiao;WANG Li;ZHOU Dongwen(Department of Obstetrics,Obstetrics and Gynecology Hospital Affiliated to Shanghai Fudan University,Shanghai 200438,China)
出处
《检验医学与临床》
CAS
2022年第8期1084-1088,共5页
Laboratory Medicine and Clinic
