外周血VCAM-1联合LFA-1对子痫前期孕妇病情严重程度的预测价值

Predictive value of peripheral blood VCAM-1 combined with LFA-1 for disease severity in preeclamptic pregnant women

摘要:

目的 探讨子痫前期孕妇外周血血管细胞黏附分子-1（VCAM-1）联合淋巴细胞功能相关抗原-1（LFA-1）对病情严重程度的预测价值。方法 选取2022年4月—2024年7月西安市第三医院收治的82例子痫前期孕妇患者的病历资料，根据子痫前期严重程度分为子痫前期组44例和重度子痫前期组38例。比较两组外周血血管细胞黏附分子-1（VCAM-1）水平、淋巴细胞功能相关抗原-1（LFA-1）阳性率，分析外周血中VCAM-1、LFA-1对子痫前期严重程度的影响和对子痫前期严重程度的预测价值。结果 子痫前期组VCAM-1水平、LFA-1阳性率均低于重度子痫前期组（P <0.05）。子痫前期组与重度子痫前期组子宫动脉阻力指数、搏动指数水平比较，差异均无统计学意义（P >0.05）。多因素逐步Logistic回归分析结果显示：外周血中VCAM-1升高［O^R=3.740（95% CI：1.987，7.040）］、LFA-1升高［O^R=4.108（95% CI：2.182，7.734）］均是子痫前期孕妇病情严重程度的危险因素（P <0.05）。受试者工作特征曲线分析结果示，外周血VCAM-1、LFA-1单一及联合预测子痫前期孕妇病情严重程度的敏感性分别为78.15%（95% CI：0.703，0.869）、74.63%（95% CI：0.635，0.821）、85.69%（95% CI：0.762，0.933），特异性分别为69.02%（95% CI：0.605，0.773）、78.85%（95% CI：0.712，0.863）、63.27%（95% CI：0.549，0.712）。结论 外周血VCAM-1、LFA-1在子痫前期患者中的表达水平异常升高，与病情严重程度密切相关，可用于预测子痫前期。

Abstract:

Objective To investigate the predictive value of peripheral blood vascular cell adhesion molecule-1 (VCAM-1) combined with lymphocyte function-associated antigen-1 (LFA-1) for disease severity in preeclamptic pregnant women.Methods Medical records of 82 preeclamptic pregnant women admitted to the Xi'an Third Hospital from April 2022 to July 2024 were analyzed. The patients were divided into a preeclampsia group (44 cases) and a severe preeclampsia group (38 cases) based on the severity of preeclampsia. The levels of VCAM-1 and the positive rate of LFA-1 in peripheral blood were compared between the two groups. The effects of VCAM-1 and LFA-1 in peripheral blood on the severity of preeclampsia and their predictive value for the severity of preeclampsia were determined.Results VCAM-1 levels and the positive rate of LFA-1 in peripheral blood were significantly lower in the preeclampsia group compared with the severe preeclampsia group (P < 0.05). No significant differences were observed in uterine artery blood flow indices, including RI and PI, between the preeclampsia and severe preeclampsia groups (P > 0.05). Multivariable stepwise logistic regression analysis (P = 0.05 for including variables and P = 0.10 for excluding variables) identified elevated peripheral blood VCAM-1 [O^R = 3.740 (95% CI: 1.987, 7.040) ] and LFA-1 [O^R = 4.108 (95% CI: 2.182, 7.734) ] as independent risk factors for severe preeclampsia (P < 0.05). Receiver operating characteristic curve analysis showed that peripheral blood VCAM-1, LFA-1, and their combination predicted severe preeclampsia with sensitivities of 78.15% (95% CI: 0.703, 0.869), 74.63% (95% CI: 0.635, 0.821), and 85.69% (95% CI: 0.762, 0.933), and specificities of 69.02% (95% CI: 0.605, 0.773), 78.85% (95% CI: 0.712, 0.863), and 63.27% (95% CI: 0.549, 0.712), respectively.Conclusion Peripheral blood VCAM-1 and LFA-1 levels are significantly elevated in patients with preeclampsia and correlate closely with disease severity, indicating their potential utility in predicting the severity of preeclampsia.