Abstract:

Objective　To explore the value of combined serum levels of Amphiregulin and cyclophilin A (CYPA) in predicting adverse pregnancy outcomes in preeclampsia patients. Methods　Ninety-six preeclampsia patients [aged (28.96±5.24) years, with a gestational age of (29.36±3.58) weeks and a body mass index (BMI) of (22.94±2.03) kg/m²] admitted to Northwest Women's and Children's Hospital from March 2020 to March 2023 were included. According to the pregnancy outcomes, the preeclampsia patients were divided into a normal outcome group (73 cases) and an adverse outcome group (23 cases). Another 50 healthy pregnant women during the same period were selected as a control group, aged (29.01±5.21) years, with a gestational age of (29.47±3.52) weeks and a BMI of (22.99±2.11) kg/m². Enzyme linked immunosorbent assay (ELISA) was used to detect the serum Amphiregulin and CYPA levels at 34-36 weeks of gestation in the three groups, and Spearman correlation analysis was used to analyze the correlations between serum Amphiregulin and CYPA levels and adverse pregnancy outcomes in preeclampsia patients. The receiver operating characteristic curve (ROC) was used to analyze the value of combined serum Amphiregulin and CYPA levels in predicting adverse pregnancy outcomes in preeclampsia patients. One-way analysis of variance and LSD-t test were used for statistical analysis. Results　Serum levels of Amphiregulin [(970.21±31.36) ng/L] and CYPA [(96.21±9.71) ng/L] in the adverse outcome group were higher than those in the normal outcome group [(862.25±27.25) ng/L and (79.58±7.22) ng/L] and the control group [(792.32±23.36) ng/L and (59.14±5.36) ng/L], with statistically significant differences (all P<0.05). Correlation analysis showed that serum levels of Amphiregulin and CYPA were positively correlated with adverse pregnancy outcomes in preeclampsia patients (r=0.855 and 0.673, both P<0.05). ROC analysis results showed that the sensitivity and specificity of serum Amphiregulin and CYPA levels combined to predict adverse pregnancy outcomes in preeclampsia patients were 91.3% and 84.9%, respectively, and the area under the curve was 0.920, which was higher than that of any single test. Conclusions　The serum levels of Amphiregulin and CYPA in preeclampsia patients are higher than those in normal pregnant women. The levels of the two indicators are positively correlated with adverse pregnancy outcomes. Their combined use can effectively predict adverse pregnancy outcomes in preeclampsia patients, showing high sensitivity and specificity.

Key words:

Preeclampsia, Amphiregulin, Cyclophilin A, Adverse pregnancy outcomes

摘要：

目的　探讨血清双调蛋白（Amphiregulin）、亲环素A（CYPA）水平联合预测子痫前期患者不良妊娠结局的价值。方法　纳入2020年3月至2023年3月西北妇女儿童医院收治的96例子痫前期患者［年龄（28.96±5.24）岁，孕周（29.36±3.58）周，体重指数（BMI）（22.94±2.03）kg/m²］，根据妊娠结局将患者分为正常结局组（73例）与不良结局组（23例）。另选取同期健康孕妇50例，年龄（29.01±5.21）岁，孕周（29.47±3.52）周，BMI（22.99±2.11）kg/m²。酶联免疫吸附试验（ELISA）检测三组研究对象孕34～36周血清Amphiregulin、CYPA水平，采用Spearman相关性分析子痫前期患者血清Amphiregulin、CYPA水平与不良妊娠结局的相关性，采用受试者操作特征曲线（receiver operating characteristic curve，ROC）分析血清Amphiregulin、CYPA水平联合预测子痫前期患者不良妊娠结局的价值。采用单因素方差分析、LSD-t检验进行统计学分析。结果　不良结局组血清Amphiregulin ［（970.21±31.36）ng/L］、CYPA水平［（96.21±9.71）ng/L］高于正常结局组［（862.25±27.25）ng/L、（79.58±7.22）ng/L］与对照组［（792.32±23.36）ng/L、（59.14±5.36）ng/L］，差异均有统计学意义（均P<0.05）。相关性分析显示，血清Amphiregulin、CYPA水平与子痫前期患者不良妊娠结局呈正相关（r=0.855、0.673，均P<0.05）。ROC分析结果显示，血清Amphiregulin、CYPA水平联合预测子痫前期患者不良妊娠结局的灵敏度、特异度分别为91.3%、84.9%，曲线下面积为0.920，高于任一单项检测。结论　子痫前期患者的血清Amphiregulin、CYPA水平高于正常孕妇。两个指标水平与不良妊娠结局呈正相关，联合使用能有效预测子痫前期患者不良妊娠结局，显示出高灵敏度和特异度。

关键词:

子痫前期, 双调蛋白, 亲环素A, 不良妊娠结局