晚期糖基化终末产物对子痫前期的诊断价值-现代医学

晚期糖基化终末产物对子痫前期的诊断价值

单位：河北省邯郸市涉县医院妇产科, 河北邯郸 056400

分类号：R714.2

出版年·卷·期（页码）：2018·46·第二期（192-196）

摘要：

目的：探讨孕妇胎盘和血清晚期糖基化终末产物（AGE）的表达及其对子痫前期的诊断价值。方法：采用酶联免疫吸附试验检测子痫前期孕妇和正常孕妇血清AGE、晚期糖基化终末产物受体（RAGE）、肿瘤坏死因子-α（TNF-α）含量，免疫组织化学染色法检测胎盘组织AGE、RAGE蛋白表达，Pearson相关检验分析血清AGE与RAGE、TNF-α的相关性，利用受试者工作曲线（ROC）计算AGE、RAGE、TNF-α诊断轻度和重度子痫前期最佳截断值。结果：轻度组、重度组血清AGE、RAGE、TNF-α含量明显高于对照组，差异具有统计学意义（P < 0.01）。与轻度组比较，重度组血清AGE、RAGE、TNF-α含量明显升高，差异具有统计学意义（P < 0.01）。轻度组血清AGE与RAGE、TNF-α呈正相关关系（r=0.667，0.732，均P<0.05）；重度组血清AGE与RAGE、TNF-α也呈正相关关系（r=0.879，0.991，均P<0.01）。AGE诊断轻度子痫前期的最佳截断值为429.7 ng·L^-1，曲线下面积为0.920（95%CI：0.846~0.966），敏感性为81.8%，特异性为88.0%；AGE诊断重度子痫前期的最佳截断值为480.1 ng·L^-1，曲线下面积为0.908（95%CI：0.823~0.960），敏感性为78.1%，特异性为92.0%。胎盘组织中，AGE和RAGE在对照组胎盘组织中呈阴性或仅可见少量阳性细胞，在轻度组中呈阳性细胞数量和染色强度明显增强；在重度组中AGE和RAGE呈强阳性表达，且阳性细胞数量和染色强度明显高于对照组和轻度组（P<0.05）。结论：子痫前期孕妇胎盘组织和血清AGE含量明显升高，AGE可以作为诊断不同病情子痫前期的指标之一。

Objective: To explore the levels of advanced glycationend products(AGE) in the placenta tissue and serum of pregnant women, and its diagnostic value for mild and severe preeclampsia. Methods: Serum concentrations of AGE, receptor for advanced glycationend products(RAGE) and tumor necrosis factor-α(TNF-α) in preeclampsia women and healthy pregnant women were measured by enzyme linked immunosorbent assay(ELSIA), the expression of AGE and RAGE in placenta tissue was measured by immunohistochemical staining in these women, the correlation between AGE and RAGE, TNF-α was analyzed by Pearson correlation test. The optimal cut-off values of the AGE, RAGE, TNF-α for mild and severe preeclampsia were determined by receiver operating characteristic curve(ROC). Results: The serum concentrations of AGE, RAGE and TNF-α in the mild group and severe group were significantly higher than those of the control group, the difference was statistically significant(P<0.01). Compared to the mild group, the contents of AGE, RAGE and TNF-α in the severe group were remarkably increased, the difference was statistically significant(P<0.01). There was an obviously correlation between the AGE and RAGE, TNF-α in the mild group(r=0.667, 0.732, all P<0.05), the same results were obtained in the severe group(r=0.879, 0.991, all P<0.01). The optimal AGE cut-off value was 429.7 ng·L^-1 for the diagnosis of mild preeclampsia, the area under curve was 0.920(95% CI:0.846~0.966), with a sensitivity and specificity was 81.8%, 88.0%, respectively. And the optimal AGE cut-off value was 480.1 ng·L^-1 for the diagnosis of severe preeclampsia, which produced an area under curve was of 0.908(95% CI:0.823~0.960), and the sensitivity and specificity was 78.1%, 92.0%, respectively. Compared to the control group, the positive expression of AGE and RAGE in the mild group and severe group was significantly enhanced, moreover, the proteins mentioned aboveshowed stronger positive expression in the severe group, the difference was statistically significant(P<0.05). Conclusion: The levels of AGE in the placenta tissue and serum of preeclampsia women are obviously increased, AGE can be used as an index for the diagnosis of mild and severe preeclampsia.

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