Mehrabian Ferdous, Jazi Sayed Mohammad Hashemi, Javanmard Shaghayegh Haghjooy, Kaviani Mahshid, Homayouni Vida
Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2012 Jan;17(1):15-21.
Circulating endothelial cells (CECs) and E-selectin are known as sensitive and specific markers of endothelial dysfunction. This study investigated whether CECs and E-selectin are surrogate biomarkers of preeclampsia and if measurement of CECs and E-selectin, early in the third trimester, could be a means of predicting preeclampsia.
In this prospective, descriptive-analytic study, rollover test was performed on 523 pregnant women during 28-30 weeks of gestation. CECs were measured by anti-CD 146-driven immunomagnetic isolation in women with positive rollover test. They were followed up prospectively until delivery without any active intervention. Women with and without preeclampsia were determined. The number of CECs and level of E-selectin were compared in the two studied groups.
From the 47 pregnant women with positive rollover test who were selected and followed up, 22 individuals were diagnosed with preeclampsia while the remainder were normotensive. Mean CEC numbers was significantly higher in preeclamptic women than normal pregnancies (24.7 cells/mL vs. 13 cells/mL). The best cut-off point for CEC numbers was 6.5 with a sensitivity of 78.9% and a specificity of 69.1%. The level of E-selectin was significantly higher in mothers with preeclampsia (p < 0.05).
Higher levels of CECs and E-selectin in women with positive rollover test who developed preeclampsia prior to onset of the complication were predictive of preeclampsia. However, larger studies are needed to confirm these findings.
循环内皮细胞（CECs）和E-选择素是已知的内皮功能障碍的敏感且特异的标志物。本研究调查了CECs和E-选择素是否是先兆子痫的替代生物标志物，以及在妊娠晚期早期测量CECs和E-选择素是否可作为预测先兆子痫的一种方法。
在这项前瞻性描述性分析研究中，对523名妊娠28 - 30周的孕妇进行了翻身试验。对翻身试验阳性的女性通过抗CD146驱动的免疫磁珠分离法测量CECs。在没有任何积极干预的情况下对她们进行前瞻性随访直至分娩。确定患有和未患有先兆子痫的女性。比较两个研究组中CECs的数量和E-选择素的水平。
在被选择并随访的47名翻身试验阳性的孕妇中，22人被诊断为先兆子痫，其余为血压正常者。先兆子痫女性的平均CECs数量显著高于正常妊娠者（24.7个细胞/毫升对13个细胞/毫升）。CECs数量的最佳截断点为6.5，敏感性为78.9%，特异性为69.1%。先兆子痫母亲的E-选择素水平显著更高（p < 0.05）。
在出现并发症之前发生先兆子痫的翻身试验阳性女性中，较高水平的CECs和E-选择素可预测先兆子痫。然而，需要更大规模的研究来证实这些发现。
