【摘要】 目的 探讨子痫前期患者血清人类白细胞抗原-G(HLA-G)、转化生长因子-β1(TGF-β1)及可溶性血管内皮生长因子受体-1(sFlt-1)水平变化，并分析三项指标对子痫前期孕妇的预测价值。方法 收集2016年4月—2020年4月在本院治疗的109例子痫前期孕妇临床资料(轻度子痫63例、重度子痫46例),并设为观察组，另选取同期在本院孕检的正常妊娠孕妇86例作为对照组。对比2组及不同程度子痫前期孕妇HLA-G、TGF-β1及sFlt-1水平，采用多因素Logistic回归分析探讨孕妇子痫前期发生的危险因素，采用受试者工作特征(ROC)曲线分析HLA-G、TGF-β1及sFlt-1联合检测对孕妇子痫前期发生的预测价值。结果 观察组HLA-G低于对照组，TGF-β1、sFlt-1高于对照组(P<0.01)。重度子痫孕妇HLA-G低于轻度子痫孕妇，TGF-β1、sFlt-1高于轻度子痫孕妇(P<0.01)。多因素Logistic回归分析显示，妊娠期高血压病、妊娠期糖尿病、HLA-G降低、TGF-β1升高、sFlt-1升高为孕妇子痫前期发生的独立危险因素(P<0.05)。HLA-G、TGF-β1及sFlt-1联合检测预测孕妇子痫前期发生的敏感度、特异度、曲线下面积均高于单一指标检测。结论 临床可对孕妇加强HLA-G、TGF-β1及sFlt-1水平监测，三项指标联合检测对孕期子痫前期发生有较大的预测价值。更多还原

【Abstract】 Objective To investigate the changes of serum human leukocyte antigen-G(HLA-G), transforming growth factor-β1(TGF-β1) and soluble vascular endothelial growth factor receptor-1(sFlt-1) levels in patients with preeclampsia, and to analyze the predictive value of three indicators for pregnant women with preeclampsia. Methods The clinical data of 109 pregnant women with preeclampsia(63 cases of mild eclampsia and 46 cases of severe eclampsia) who were treated in our hospital from April 2016 to April 2020 were collected and set as the observation group. Eighty-six healthy pregnant women who undewent pregnancy examination were selected as the control group. The levels of HLA-G, TGF-β1 and sFlt-1 in the two groups and in pregnant women with different degrees of preeclampsia were compared, and multivariate Logistic regression analysis was used to explore the risk factors of preeclampsia in pregnant women. The receiver operating characteristic(ROC) curve was used to analyze the predictive value of combined detection of HLA-G, TGF-β1 and sFlt-1 in pregnant women with preeclampsia. Results HLA-G in the observation group was lower than that in the control group, while TGF-β1 and sFlt-1 were higher than those in the control group(P<0.01). The HLA-G of patients with severe eclampsia was lower than that of patients with mild eclampsia, and the levels of TGF-β1 and sFlt-1 were higher than those of patients with mild eclampsia(P<0.01). Multivariate Logistic regression analysis showed that gestational hypertension, gestational diabetes, decreased HLA-G, increased TGF-β1, and increased sFlt-1 were independent risk factors for preeclampsia in pregnant women(P<0.05). The combined detection of HLA-G, TGF-β1 and sFlt-1 had higher sensitivity, specificity and area under the ROC curve than single index detection in predicting the occurrence of preeclampsia in pregnant women. Conclusion In clinical practice, HLA-G, TGF-β1 and sFlt-1 levels in pregnant women should be monitored, and the combined detection of the three indicators has greater predictive value for the occurrence of preeclampsia during pregnancy.更多还原