产妇及脐带降钙素原、超敏 C 反应蛋白、白细胞介素 6 在子痫前期与血压正常孕妇中的水平：一项横断面研究。

Maternal and umbilical cord procalcitonin, high-sensitivity C-reactive protein, and interleukin-6 levels in preeclamptic and normotensive patients: A cross-sectional study.

机构信息

Department of Obstetrics and Gynecology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States.

Department of Obstetrics and Gynecology, Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosi, Mexico.

出版信息

Pregnancy Hypertens. 2020 Jul;21:218-223. doi: 10.1016/j.preghy.2020.04.009. Epub 2020 Apr 30.

DOI:10.1016/j.preghy.2020.04.009

PMID:32683282

Abstract

OBJECTIVES

To report maternal and umbilical vein levels of procalcitonin (PCT) in patients with preeclampsia (PE) compared to controls. As secondary aims, we measured high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6). Moreover, correlation analyses were performed between the inflammatory biomarkers and mean arterial pressure (MAP).

STUDY DESIGN

This was a single center, cross-sectional study.

MAIN OUTCOME MEASURES

After Institutional Review Board approval and written informed consent, patients with or without PE were enrolled. PCT, hs-CRP, and IL-6 levels were compared between groups using multiple linear regression models. We calculated the adjusted ratios of geometric means (aRGM) for the comparison of patients with and without PE. Correlation analysis between the inflammatory biomarkers and MAP was performed using Spearman's method.

RESULTS

A total of 156 participants were enrolled, yielding 156 venous blood samples and umbilical venous blood samples. Seventy-six patients were in the PE group, and 80 patients were in the control group. Maternal plasma and serum concentrations of PCT (aRGM 3.35 (95% confidence interval [CI]: 2.26, 4.95; p < 0.001)), hs-CRP (aRGM 1.85 (95% CI: 1.30, 2.63; p = 0.003)), and IL-6 (aRGM 1.49 (95% CI: 1.08, 2.04; p = 0.045)) were higher in the PE group. In umbilical venous samples, the concentrations of PCT (aRGM 2.54 (95% CI: 1.46, 4.44; p = 0.003)) and hs-CRP (aRGM 1.45 (95% CI: 1.13, 1.87; p = 0.012)) in the PE group were higher than the controls. No difference in umbilical venous IL-6 concentrations were detected between PE vs. control groups (aRGM 1.46; 95% CI: 1.07, 1.98; p = 0.051). There was positive correlation for both PCT and hs-CRP with MAP in maternal and umbilical venous samples. However, there was no correlation between IL and 6 and MAP in maternal or umbilical venous samples.

CONCLUSIONS

PCT levels were elevated in maternal and umbilical venous samples of patients with PE, and correlated with disease severity.

摘要

目的

报告先兆子痫（PE）患者与对照组相比，母体和脐静脉降钙素原（PCT）水平。作为次要目标，我们测量了高敏 C 反应蛋白（hs-CRP）和白细胞介素 6（IL-6）。此外，还对炎症生物标志物与平均动脉压（MAP）之间进行了相关性分析。

设计

这是一项单中心、横断面研究。

主要观察指标

在获得机构审查委员会批准和书面知情同意后，纳入有或无 PE 的患者。使用多元线性回归模型比较两组 PCT、hs-CRP 和 IL-6 水平。我们计算了患者与对照组之间比较的几何均数调整比（aRGM）。采用 Spearman 法对炎症生物标志物与 MAP 之间的相关性进行分析。

结果

共纳入 156 名参与者，共采集 156 份静脉血和脐静脉血样本。76 名患者为 PE 组，80 名患者为对照组。母体血浆和血清 PCT（aRGM 3.35（95%置信区间[CI]：2.26，4.95；p<0.001））、hs-CRP（aRGM 1.85（95%CI：1.30，2.63；p=0.003））和 IL-6（aRGM 1.49（95%CI：1.08，2.04；p=0.045））浓度在 PE 组中较高。在脐静脉样本中，PE 组 PCT（aRGM 2.54（95%CI：1.46，4.44；p=0.003））和 hs-CRP（aRGM 1.45（95%CI：1.13，1.87；p=0.012））浓度高于对照组。PE 组与对照组的脐静脉 IL-6 浓度无差异（aRGM 1.46；95%CI：1.07，1.98；p=0.051）。母体和脐静脉样本中 PCT 和 hs-CRP 与 MAP 呈正相关。然而，母体和脐静脉样本中 IL-6 与 MAP 之间无相关性。