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临床输血与检验

临床输血与检验 ›› 2021, Vol. 23 ›› Issue (4): 482-487.DOI: 10.3969/j.issn.1671-2587.2021.04.016

• 临床研究 • 上一篇    下一篇

CXCL12/CXCR4与子痫前期及其肝功能异常的相关性研究*

蒋晓敏, 周小娟, 李意   

  1. 230001 安徽省妇幼保健院
  • 收稿日期:2020-12-28 发布日期:2021-08-18
  • 作者简介:蒋晓敏（1980-）,女,副主任医师,主要从事妇产科相关研究工作,（E-mail）30425973@qq.com。
  • 基金资助:
    *本课题受合肥市卫生和计划生育委员会应用医学研究重点项目（No.hwk2018zd013）资助

Correlation Study of CXCL12/CXCR4 with Preeclampsia and Abnormal Liver Function

JIANG Xiao-min, ZHOU Xiao-juan, LI Yi   

  1. Affiliated Maternal and Child Health Hospital of Anhui Medical University,Hefei 230001
  • Received:2020-12-28 Published:2021-08-18

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摘要： 目的 比较子痫前期患者和正常孕妇血清趋化因子CXCL12/CXCR4的水平,分析其与子痫前期孕妇肝功能异常的相关性。方法 选取2018年5月~2019年5月于安徽医科大学附属妇幼保健院住院行剖宫产分娩的子痫前期患者65例（PE组）和正常妊娠孕妇51例（对照组）,将PE患者进一步分为轻度PE患者23例（轻度PE组）和重度PE患者42例（重度PE组）。比较对照组与轻、重度PE组间的一般临床资料、血清CXCL12/CXCR4及ALT、AST水平;检验血清CXCL12/CXCR4水平与子痫前期孕妇肝功能异常的相关性,计算CXCL12/CXCR4诊断子痫前期的灵敏度、特异度,采用ROC曲线评价预测模型的准确性。结果 重度PE组分娩孕周及新生儿出生体重明显低于对照组及轻度PE组（P<0.001）;两两比较对照组、轻度PE组及重度PE组母体血清CXCL12/CXCR4水平差异存在统计学意义,且逐渐降低（P均<0.017）;重度PE组母体血清ALT水平明显高于轻度PE组及对照组,重度PE组及轻度PE组母体血清AST水平明显高于对照组（P<0.017）;ROC曲线分析结果显示,血清CXCL12以2 477.68 pg/mL为最佳截断值,诊断子痫前期的ROC曲线下面积为0.981,灵敏度为92%,特异度为94%,（95%CI：0.963-0.999）;血清CXCR4以2125.97 pg/mL作为最佳截断值,诊断子痫前期的ROC曲线下面积为0.996,灵敏度为95.4%,特异度为100%,（95%CI：0.960-1.000）;Spearman相关分析显示母体血清CXCL12与ALT（r=-0.486）、AST（r=-0.386）呈显著负相关,母体血清CXCR4也与ALT（r=-0.474）、AST（r=-0.403）呈负相关,差异有统计学意义（P<0.001）。结论 母体血清CXCL12/CXCR4水平降低与子痫前期相关,并可能参与子痫前期孕妇肝功能异常的发病机制。

关键词: 子痫前期, CXC类趋化因子配体12, CXC趋化因子受体4, 谷丙转氨酶, 谷草转氨酶

Abstract: Objective To compare the serum chemokine CXCL12/CXCR4 levels between patients with preeclampsia and normal pregnant women, and ananlyze its correlation with abnormal liver function of pregnant women with preeclampsia. Methods 65 patients with preeclampsia （PE group） and 51 normal pregnant women （control group） who underwent cesarean section in the affiliated Maternal and Child Health Hospital of Anhui Medical University from May 2018 to May 2019 were enrolled. Patients in PE group were further divided into mild PE group （23 patients） and severe PE group （42 patients）. We compared general clinical data,serum CXCL12/CXCR4,ALT and AST levels among three groups, and evaluated the correlation between the serum CXCL12/CXCR4 levels and abnormal liver function in pregnant women with preeclampsia and calculate their sensitivity and specificity. ROC curve was used to evaluate the accuracy of this prediction model. Results The gestational age of patients and birthweight of newborns in severe PE group were significantly lower than those in control group and mild PE group （P<0.001）. Pairwise comparison of the maternal serum CXCL12/CXCR4 levels of the control group, mild PE group and severe PE group were statistically different,and gradually decreased （all P<0.017）. The serum ALT of severe PE group was significantly higher than that of mild PE group and control group, while the serum AST of severe PE group and mild PE group was significantly higher than control group（P<0.017）. ROC curve analysis results showed that the area under the ROC curve （AUC） for the diagnosis of preeclampsia was 0.981 with serum CXCL12 as the best cut-off value of 2477.68pg/mL [sensitivity was 92%;specificity was 94% （95%CI： 0.963-0.999）],and AUC was 0.996 withserum CXCR4 as the best cut-off value of 2125.97pg/mL [sensitivity was 95.4%; specificity was 100% （95%CI： 0.960-1.000）]. Spearman correlation analysis showed that maternal serum CXCL12 level was negatively related with ALT（r=-0.486） and AST（r=-0.386）, and CXCR4 level was also negatively related with ALT（r=-0.474）and ASTr=-0.403）（P<0.001）. Conclusion Decreased maternal serum CXCL12/CXCR4 levels are related with preeclampsia and may be involved in the pathogenesis of abnormal liver function in pregnant women with preeclampsia.

Key words: Preeclampsia, CXC chemokine ligand 12, CXC chemokine receptor 4, Alanine aminotransferase, Aspartate aminotransferase

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