血清FFA、PLGF、tTG、T-cadherin与早发型子痫前期患者子宫动脉血流参数和围产儿不良结局的关系研究

摘要 目的：探讨血清组织型转谷氨酰胺酶（tTG）、胎盘生长因子（PLGF）、游离脂肪酸（FAA）、T-钙粘蛋白（T-cadherin）与早发型子痫前期（EOPE）患者子宫动脉血流参数的关系，并分析围产儿不良结局的影响因素。方法：选择2019年9月~2021年5月在我院接受治疗的116例EOPE患者作为EOPE组，另选取同期80例来我院例行产检的健康志愿者孕妇作为对照组。对比EOPE组、对照组的血清FFA、PLGF、tTG、T-cadherin水平和子宫动脉血流参数。采用Pearson法分析血清FFA、PLGF、tTG、T-cadherin与EOPE患者子宫动脉血流参数的相关性。采用多因素Logistic回归分析围产儿不良结局的危险因素。结果：EOPE组的血清FFA、tTG高于对照组，PLGF、T-cadherin则低于对照组（P<0.05）。EOPE组的阻力指数（RI）、收缩期和舒张期血流流速比值（S/D）、搏动指数（PI）高于对照组（P<0.05）。Pearson相关性分析结果显示，RI、PI、S/D与FFA、tTG均呈正相关，而与PLGF、T-cadherin均呈负相关（P<0.05）。多因素Logistic回归分析结果显示，白蛋白偏低、丙氨酸氨基转氨酶偏高、血肌酐偏高、FFA偏高、PLGF偏低、tTG偏高、T-cadherin偏低、RI偏高、PI偏高、S/D偏高均是围产儿不良结局的危险因素（P<0.05）。结论：EOPE患者血清中FFA、tTG表达升高，PLGF、T-cadherin表达下降，且与子宫动脉血流参数具有一定的相关性。白蛋白、丙氨酸氨基转氨酶、血肌酐等均是围产儿不良结局的危险因素，应加强对上述指标的监测，尽早进行相关干预，以降低围产儿不良结局的发生率。

Relationship Study between Serum FFA, PLGF, tTG, T-cadherin and Uterine Artery Blood Flow Parameters and Adverse Perinatal Outcomes in Patients with Early-Onset Preeclampsia

ABSTRACT Objective: To investigate the relationship between serum tissue transglutaminase (tTG), placental growth factor (PLGF), free fatty acid (FAA), T-cadherin (T-cadherin) and uterine artery blood flow parameters in patients with early-onset preeclampsia (EOPE), and to analyze the influencing factors of adverse perinatal outcomes. Methods: 116 patients with EOPE who were treated in our hospital from September 2019 to May 2021 were selected as the EOPE group, and 80 healthy volunteer pregnant women who came to our hospital for routine prenatal examination in the same period were selected as the control group. The levels of serum FFA, PLGF, tTG, T-cadherin and uterine artery blood flow parameters were compared between EOPE group and control group. Pearson method was used to analyze the correlation between serum FFA, PLGF, tTG, T-cadherin and uterine artery blood flow parameters in patients with EOPE. Multivariate Logistic regression was used to analyze the risk factors of adverse perinatal outcomes. Results: Serum FFA and tTG of EOPE group were higher than those of the control group, while PLGF and T-cadherin were lower than those of the control group (P<0.05). The resistance index (RI), systolic and diastolic blood flow velocity ratio (S/D), pulsatility index (PI) of EOPE group were higher than those of control group(P<0.05). Pearson correlation analysis showed that RI, PI and S/D were positively correlated with FFA and tTG, but negatively correlated with PLGF and T-cadherin (P<0.05). Multivariate Logistic regression analysis showed that low albumin, high alanine aminotransferase, high serum creatinine, high FFA, low PLGF, high tTG, low T-cadherin, high RI, high PI and high S/D were risk factors for adverse perinatal outcomes(P<0.05). Conclusion: The expression of FFA and tTG in serum of EOPE patients increased, while the expression of PLGF and T-cadherin decreased, which are correlated with uterine artery blood flow parameters. Albumin, alanine aminotransferase and serum creatinine are risk factors for adverse perinatal outcomes. The monitoring of the above indicators should be strengthened and relevant interventions should be carried out as soon as possible to reduce the incidence of adverse perinatal outcomes.