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妊娠期高血压疾病循环补体预测标志物的筛选与初步验证

Screening and preliminary verification of predictive markers of circulating complement factors in hypertensive disorder of pregnancy

摘要:

目的:基于妊娠期高血压和蛋白尿发生的报道寻找预测妊娠期高血压疾病(HDP)的循环补体相关蛋白,探讨补体系统在HDP发生发展中的作用。方法:采用巢式病例对照研究,收集2014年11月至2017年3月于广州市妇女儿童医疗中心产检并分娩的孕妇孕20周前血清,共纳入60例HDP和60例正常孕妇,按年龄和孕周1∶1配对。采用非标记蛋白质谱方法筛选12对血清标本中差异表达的补体蛋白,余48对用于初步验证。当差异倍数(FC)>1.2或<0.8,且 P<0.05时入选。用受试者工作特征(ROC)曲线下面积(AUC)评价相应因子的预测价值。 结果:高血压孕妇血清补体C1亚单位(C1s)、C8 beta链(C8β)、C1抑制剂(C1-INH)的FC分别为1.19、1.23、0.73( t=2.07,2.06,-3.40; P均<0.05);子痫前期(PE)孕妇C1s、C8β、C1-INH、H因子相关蛋白5(CFHR5)、丛生蛋白(CLU)、C反应蛋白(CRP)的FC分别为1.39、1.50、0.72、2.49、4.38和1.82( t=4.36,5.61,-3.70,6.82,8.70,7.27; P均<0.05)。C1s、C8β和C1-INH联合对HDP的AUC值为0.89。CFHR5、CLU和CRP对PE的AUC值分别为0.88、0.92和0.91。 结论:HDP发生前,孕妇体内已出现补体经典途径和旁路途径的激活及调节紊乱。补体C1s、C8β、C1-INH联合检测有望用于HDP的预测,CFHR5、CLU、CRP可能是肾脏损伤性HDP的潜在预测分子标志。

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abstracts:

Objective:To search for circulating complement-related proteins that predict hypertensive disorders of pregnancy (HDP) based on reports of the development of gestational hypertension and proteinuria and to investigate the role of the complement system in the development of HDP.Methods:A nested case-control study was used, the serum samples of pregnant women who had been given birth or cesarean section in Guangzhou Women and Children′s Medical Center from November 2014 to March 2017 were collected. A total of 60 HDP and 60 normal pregnant women were included and matched 1∶1 by age and gestational week. Unlabeled mass spectrometry was used to screen the differential expression of complement factors in serum samples of 12 pairs of HDP patients and normal pregnancy collected before 20 weeks of pregnancy, and another 48 pairs of serum samples of HDP patients and normal pregnant women were used for preliminary verification. It was selected when the fold change (FC) of complement factor expression was>1.2 or <0.8 and P<0.05. ROC curve was used to evaluate the diagnostic value of corresponding factors. Results:FC of serum C1s, C8 beta chain (C8β) and C1 inhibitor (C1-INH) of HDP patients were 1.19, 1.23, 0.73 ( t=2.07, 2.06, -3.40; P<0.05), respectively. FC of serum C1s, C8 β, C1-INH, factor H-related protein 5 (CFHR5), clusterin (CLU), and C-reactive protein (CRP) of PE patients were 1.39, 1.50, 0.72, 2.49,4.38, and 1.82 respectively ( t=4.36, 5.61, -3.70, 6.82, 8.70, 7.27; P<0.05).The AUC of combining C1s, C8 β and C1-INH was 0.89 in HDP. The AUC of CFHR5, CLU, and CRP in preeclampsia was 0.88, 0.92, and 0.91. Conclusions:Before HDP, the activation and regulation of classic complement pathway and alternative pathway were disordered in pregnant women. The combined detection of complement C1s, C8 β and C1-INH is expected to be used in the prediction of HDP, and CFHR5, CLU, and CRP are expected to be used in the prediction of preeclampsia.

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期刊: 《中华检验医学杂志》2020年43卷9期 901-906页 ISTICPKUCSCDCA
栏目名称: 论著
DOI: 10.3760/cma.j.cn114452-20200222-00105
发布时间: 2020-09-28
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