孕妇血清L-精氨酸水平检测对妊高症的预测价值分析
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摘要
目的评估血清L-精氨酸的浓度在预测妊娠期高血压症(pregnancy induced hypertension,PIH)发展中是否起到作用,分析其作为临床预测指标的有效性。方法研究共纳入186例妊娠期孕妇,出现妊娠期高血压症(PIH)的孕妇为实验组,健康孕妇为对照组,对其进行回顾性调查研究,对比健康孕妇和妊娠期高血压症孕妇(FPIH)在妊娠期不同阶段血清L-精氨酸以及脐带血血清L-精氨酸的浓度,分析血清L-精氨酸和脐带血血清L-精氨酸在妊娠期高血压发展中的诊断效能。结果实验组和对照组受试者在年龄(X~2=2.426,P=0.119;t=1.218,P=0.229)和妊娠前吸烟(X~2=2.088,P=0.148)方面差异无统计学意义,但两组患者的BMI(X~2=8.772,P=0.003)和孕产次(X~2=6.083,P=0.014)差异有统计学意义。两组受试者妊娠不同阶段的血清L-精氨酸的浓度差异无统计学意义,且脐带血血清L-精氨酸的浓度差异也无统计学意义。孕产次不同的受试者,脐带血血清L-精氨酸的浓度差异有统计学意义,年龄,BMI和以及是否吸烟等特征不同的受试者,血清L-精氨酸浓度和脐带血血清L-精氨酸浓度无显著差异。血清L-精氨酸浓度和脐带血血清L-精氨酸浓度的ROC曲线分析结果显示,其对妊娠期高血压的诊断效能较低。结论妊娠期孕妇L-精氨酸水平与PIH的发展与BMJ和孕产次存在相关性。但由于样本量限制,L-精氨酸对PIH的诊断效能分析还需要更进一步研究确定。
Objective The evaluate action of serum L-arginine levels for predicting development of pregnant women with PIH,and analyze its effectiveness as clinical predictor. Methods. Collecting 186 patients was performed a retrospective study. The PIH pregnant women was the experiment group,and the health pregnant women was the control group. In order to analyse the effect,the levels of L-arginine were measured in the early,middle and late period of pregnant women. Compared with the serum L-arginine in different groups with X~2-test and t-test based on data type. Results Experimental group and control group subjects in age(X~2 =2. 426,P=0. 119;t=1. 218,P=0. 229) and smoking before pregnancy(X~2=2. 088,P=2. 088),there was no significant differences,but the two groups of patients with BMI(X~2=8. 772,P=0. 003) and parity(X~2=6. 083,P=0. 014) was statistically. In different stages of pregnancy,the concentration of serum L-arginine had no statistical differences, and in the concentration of umbilical cord blood,serum L-arginine also had no statistical difference. There was a statistical differences in the serum L-arginine concentration of the cord blood for different number of pregnancies,but the concentrations of L-arginine in cord blood and in serum L-arginine. There were no significant difference in age, BMI and smoking pregnant. According to ROC curve analysis, for the diagnostic of concentration in serum L-arginine and in umbilical cord blood,the results indicate low efficiency to the diagnosis of pregnancy hypertension during pregnancy, Conclusion Larginine level and the development of PIH and body mass index and maternal correlation for the pregnant women, Because the sample size limitations,L-arginine in the diagnosis of PIH also needs to be further research to determine the effectiveness of predicting.
Objective The evaluate action of serum L-arginine levels for predicting development of pregnant women with PIH,and analyze its effectiveness as clinical predictor. Methods. Collecting 186 patients was performed a retrospective study. The PIH pregnant women was the experiment group,and the health pregnant women was the control group. In order to analyse the effect,the levels of L-arginine were measured in the early,middle and late period of pregnant women. Compared with the serum L-arginine in different groups with X~2-test and t-test based on data type. Results Experimental group and control group subjects in age(X~2 =2. 426,P=0. 119;t=1. 218,P=0. 229) and smoking before pregnancy(X~2=2. 088,P=2. 088),there was no significant differences,but the two groups of patients with BMI(X~2=8. 772,P=0. 003) and parity(X~2=6. 083,P=0. 014) was statistically. In different stages of pregnancy,the concentration of serum L-arginine had no statistical differences, and in the concentration of umbilical cord blood,serum L-arginine also had no statistical difference. There was a statistical differences in the serum L-arginine concentration of the cord blood for different number of pregnancies,but the concentrations of L-arginine in cord blood and in serum L-arginine. There were no significant difference in age, BMI and smoking pregnant. According to ROC curve analysis, for the diagnostic of concentration in serum L-arginine and in umbilical cord blood,the results indicate low efficiency to the diagnosis of pregnancy hypertension during pregnancy, Conclusion Larginine level and the development of PIH and body mass index and maternal correlation for the pregnant women, Because the sample size limitations,L-arginine in the diagnosis of PIH also needs to be further research to determine the effectiveness of predicting.
引文
[1]Roberts BW,Mitchell J,Kilgannon JH,et al.Nitric oxide donor agents for the treatment of ischemia/reperfusion injury in human subjects:a systematic review[J].Shock,2013,39(3):229-239.
[2]Khalil A,Hardman L,O'Brien P.The role of arginine,homoarginine and nitric oxide in pregnancy[J].Amino Acids,2015,47(9):1715-1727.
[3]Kintiraki E,Papakatsika S,Kotronis G,et al.Pregnancy-induced hypertension[J].Hormones(Athens Greece),2015,14(2):211-223.
[4]潘秀林,朱玩秀.妊高症患者血清CysC,HCY及mALB联合检测的临床意义[J].现代检验医学杂志,2015,30(3):145-146,150.Pan XL,Zhu WX.Clinical significance of serum Cys C,HCY and mALB joint detection to HDCP patients[J].J Mod Lab Med,2015,30(3):145-146,150.
[5]Hristina K,Langerholc T,Trapecar M.Novel metabolic roles of L-arginine in body energy metabolism and possible clinical applications[J].The Journal of Nutrition,Health&Aging,2014,18(2):213-218.
[6]Tamás P,Bódis J,Sulyok E,et al.L-arginine metabolism in early-onset and late-onset pre-eclamptic pregnancies[J].Scandinavian Journal of Clinical and Laboratory Investigation,2013,73(5):436-443.
[7]王忠民,汪洁萍,叶萍.L-精氨酸对妊髙征的治疗作用及其机制的探讨[J].微循环学杂志,2004,14(1):31-33.Wang ZM,Wang JP,Ye Ping.Effect and mechanism of L-Arginine in treating pregnancy induced hypertension'syndrome[J].Chinese Journal of Microcirculation,2004,14(1):31-33.
[8]Sobczak A,Prokopowicz A,Radek M,et al.Tobacco smoking decreases plasma concentration of the emerging cardiovascular risk marker,L-homoarginine[J].Circulation Journal,2014,78(5):1254-1258.
[9]Dorniak-Wall T,Grivell RM,Dekker GA,et al.The role of L-arginine in the prevention and treatment of pre-eclampsia:a systematic review of randomised trials[J].Journal of Human Hypertension,2014,28(4):230-235.
[10]Pimentel AM,Pereira NR,Costa CA,et al.L-arginine-nitric oxide pathway and oxidative stress in plasma and platelets of patients with pre-eclampsia[J].Hypertension Research,2013,36(9):783-788,
[11]Herrera-Garcia G,Contag S.Maternal preeclampsia and risk for cardiovascular disease in offspring[J].Current Hypertension Reports,2014,16(9):475.
[12]Bener A,Saleh NM.The impact of socio-economic,lifestyle habits,and obesity in developing of pregnancy-induced hypertension in fast-growing country:global comparisons[J].Clinical and Experimental Obstetrics&Gynecology,2012,40(1):52-57.
[13]Khalil AA,Tsikas D,Akolekar R,et al.Asymmetric dimethylarginine,arginine and homoarginine at 11-13 weeks'gestation and preeclampsia:a case-control study[J].Journal of Human Hypertension,2013,27(1):38-43.
[14]顾益凤,朱自力,张金业,等.利用ROC曲线选择血清HE-4对卵巢癌的最佳诊断界点[J].现代检验医学杂志,2015,30(4):141-143.Gu YF,Zhu ZL,Zhang JY,et al.Selecting the best cut-off point of serum HE-4 in ovarian cancer by ROC curve[J].J Mod Lab Med,2015,30(4):141-143.
[2]Khalil A,Hardman L,O'Brien P.The role of arginine,homoarginine and nitric oxide in pregnancy[J].Amino Acids,2015,47(9):1715-1727.
[3]Kintiraki E,Papakatsika S,Kotronis G,et al.Pregnancy-induced hypertension[J].Hormones(Athens Greece),2015,14(2):211-223.
[4]潘秀林,朱玩秀.妊高症患者血清CysC,HCY及mALB联合检测的临床意义[J].现代检验医学杂志,2015,30(3):145-146,150.Pan XL,Zhu WX.Clinical significance of serum Cys C,HCY and mALB joint detection to HDCP patients[J].J Mod Lab Med,2015,30(3):145-146,150.
[5]Hristina K,Langerholc T,Trapecar M.Novel metabolic roles of L-arginine in body energy metabolism and possible clinical applications[J].The Journal of Nutrition,Health&Aging,2014,18(2):213-218.
[6]Tamás P,Bódis J,Sulyok E,et al.L-arginine metabolism in early-onset and late-onset pre-eclamptic pregnancies[J].Scandinavian Journal of Clinical and Laboratory Investigation,2013,73(5):436-443.
[7]王忠民,汪洁萍,叶萍.L-精氨酸对妊髙征的治疗作用及其机制的探讨[J].微循环学杂志,2004,14(1):31-33.Wang ZM,Wang JP,Ye Ping.Effect and mechanism of L-Arginine in treating pregnancy induced hypertension'syndrome[J].Chinese Journal of Microcirculation,2004,14(1):31-33.
[8]Sobczak A,Prokopowicz A,Radek M,et al.Tobacco smoking decreases plasma concentration of the emerging cardiovascular risk marker,L-homoarginine[J].Circulation Journal,2014,78(5):1254-1258.
[9]Dorniak-Wall T,Grivell RM,Dekker GA,et al.The role of L-arginine in the prevention and treatment of pre-eclampsia:a systematic review of randomised trials[J].Journal of Human Hypertension,2014,28(4):230-235.
[10]Pimentel AM,Pereira NR,Costa CA,et al.L-arginine-nitric oxide pathway and oxidative stress in plasma and platelets of patients with pre-eclampsia[J].Hypertension Research,2013,36(9):783-788,
[11]Herrera-Garcia G,Contag S.Maternal preeclampsia and risk for cardiovascular disease in offspring[J].Current Hypertension Reports,2014,16(9):475.
[12]Bener A,Saleh NM.The impact of socio-economic,lifestyle habits,and obesity in developing of pregnancy-induced hypertension in fast-growing country:global comparisons[J].Clinical and Experimental Obstetrics&Gynecology,2012,40(1):52-57.
[13]Khalil AA,Tsikas D,Akolekar R,et al.Asymmetric dimethylarginine,arginine and homoarginine at 11-13 weeks'gestation and preeclampsia:a case-control study[J].Journal of Human Hypertension,2013,27(1):38-43.
[14]顾益凤,朱自力,张金业,等.利用ROC曲线选择血清HE-4对卵巢癌的最佳诊断界点[J].现代检验医学杂志,2015,30(4):141-143.Gu YF,Zhu ZL,Zhang JY,et al.Selecting the best cut-off point of serum HE-4 in ovarian cancer by ROC curve[J].J Mod Lab Med,2015,30(4):141-143.