Department of Laboratory Medicine, Peking University Third Hospital, Beijing, China (mainland).
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China (mainland).
Med Sci Monit. 2019 Sep 21;25:7087-7093. doi: 10.12659/MSM.915777.
BACKGROUND This study aimed to determine the diagnostic role of serum levels of complement C1q, Bb, and H in nonpregnant women, women with normal pregnancy, and women with severe pre-eclampsia. MATERIAL AND METHODS Healthy nonpregnant women (n=30), women with early, middle, and late normal pregnancy (n=30, respectively), and women with severe pre-eclampsia (n=73) were studied. The pre-eclampsia study group included early-onset cases (n=43) and late-onset cases (n=30). Serum levels of Bb were determined by enzyme-linked immunosorbent assay (ELISA), and C1q and H were tested by a turbidimetric immunoassay method. RESULTS In the pre-eclampsia study group, compared with women with normal pregnancy, serum levels of C1q remained stable throughout pregnancy, and Bb levels declined from mid-pregnancy (p=0.250). Serum levels of factor H increased in the middle and late stages of pregnancy, and C1q and H were lower in early-onset severe pre-eclampsia (p<0.001, p=0.009, respectively) and late-onset severe pre-eclampsia (p<0.001, p=0.031, respectively) compared with the early-onset control and late-onset control groups. Serum levels of Bb increased in early-onset severe pre-eclampsia (p=0.001) and late-onset severe pre-eclampsia (p=0.003) compared with early-onset control and late-onset control groups. The area under the receiver operator curve (ROC) for serum C1q, Bb, and H for the diagnosis of early-onset severe pre-eclampsia were 0.814 (95% CI, 0.712-0.917), 0.743 (95% CI, 0.638-0.859), and 0.681(95% CI, 0.556-0.806), and late-onset severe pre-eclampsia were 0.805 (95% CI, 0.694-0.913), 0.796 (95% CI, 0.680-0.911), and 0.662 (95% CI, 0.524-0.800). CONCLUSIONS The classical and alternative pathways of complement were activated in patients with severe pre-eclampsia. Serum levels of C1q, Bb, and H should be studied further as potential diagnostic markers for severe pre-eclampsia.
本研究旨在确定血清补体 C1q、Bb 和 H 水平在非孕妇、正常妊娠妇女和重度子痫前期妇女中的诊断作用。
研究纳入了 30 名健康非孕妇、30 名早、中、晚期正常妊娠妇女和 73 名重度子痫前期妇女。子痫前期研究组包括早发型（n=43）和晚发型（n=30）病例。采用酶联免疫吸附试验（ELISA）测定 Bb 水平，采用比浊免疫法检测 C1q 和 H 水平。
在子痫前期组中，与正常妊娠妇女相比，C1q 水平在整个孕期保持稳定，而 Bb 水平从中孕期开始下降（p=0.250）。H 因子水平在中晚期妊娠时升高，早发型重度子痫前期（p<0.001，p=0.009）和晚发型重度子痫前期（p<0.001，p=0.031）的 C1q 和 H 水平均低于早发型对照组和晚发型对照组。早发型重度子痫前期（p=0.001）和晚发型重度子痫前期（p=0.003）的 Bb 水平均高于早发型对照组和晚发型对照组。血清 C1q、Bb 和 H 对早发型重度子痫前期的诊断的受试者工作特征曲线（ROC）下面积分别为 0.814（95%CI，0.712-0.917）、0.743（95%CI，0.638-0.859）和 0.681（95%CI，0.556-0.806），对晚发型重度子痫前期的诊断分别为 0.805（95%CI，0.694-0.913）、0.796（95%CI，0.680-0.911）和 0.662（95%CI，0.524-0.800）。
补体经典和替代途径在重度子痫前期患者中被激活。C1q、Bb 和 H 水平应进一步作为重度子痫前期的潜在诊断标志物进行研究。
