对诊断为子痫前期的孕妇血清神经丝氨酸蛋白酶水平的调查：一项前瞻性病例对照研究。
Investigation of serum neuroserpin levels in pregnant women diagnosed with pre-eclampsia: a prospective case-control study.
作者信息
Ucok Belgin Savran, Firatligil Fahri Burcin, Sucu Sadun, Ozkan Sadullah, Kurt Dilara, Yucel Kadriye Yakut
机构信息
Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara, Turkey.
Division of Perinatology, Department of Obstetrics and Gynecology, Ankara Bilkent City Hospital, Ankara, Turkey.
出版信息
BMC Pregnancy Childbirth. 2025 May 10;25(1):559. doi: 10.1186/s12884-025-07673-2.
OBJECTIVE
Neuroserpin, a serine protease inhibitor, is recognized for its anti-inflammatory and neuroprotective properties. Given the central role of inflammation and neurological involvement in the pathophysiology of preeclampsia, this study aimed to assess maternal serum neuroserpin levels in preeclamptic pregnancies and explore their association with disease severity.
DESIGN
Prospective case-control study.
SETTING
A tertiary referral center in Ankara, Türkiye.
POPULATION
Singleton pregnant women with a diagnosis of preeclampsia (n = 44) and gestational age-matched normotensive pregnant women as controls (n = 44).
METHODS
Participants were assigned to preeclampsia and control groups. Serum neuroserpin levels were quantified using enzyme-linked immunosorbent assay (ELISA). Subgroup analysis was conducted based on the clinical severity of preeclampsia. Statistical analysis included group comparisons, receiver operating characteristic (ROC) curve analysis, and correlation testing.
MAIN OUTCOME MEASURES
The primary outcome was maternal serum neuroserpin level. Secondary outcomes included obstetric and neonatal parameters such as gestational age at delivery, delivery mode, NICU admission, and Apgar scores.
RESULTS
Serum neuroserpin levels were significantly reduced in the preeclampsia group compared to controls (p = 0.018). Within the preeclampsia cohort, patients with severe disease exhibited even lower neuroserpin concentrations than those with mild preeclampsia. ROC curve analysis determined a neuroserpin cutoff value of ≤ 22.95 ng/mL for identifying preeclampsia (AUC: 0.647, p = 0.013) and ≤ 14.7 ng/mL for severe preeclampsia (AUC: 0.740, p = 0.007).
CONCLUSION
Reduced maternal serum neuroserpin levels are associated with both the diagnosis and severity of preeclampsia. These findings highlight the potential role of neuroserpin in the disease's inflammatory mechanisms and support its utility as a candidate biomarker in clinical prediction models.
CLINICAL TRIAL REGISTRATION
Not applicable.
目的
神经丝氨酸蛋白酶抑制剂（Neuroserpin）是一种丝氨酸蛋白酶抑制剂，因其抗炎和神经保护特性而受到认可。鉴于炎症和神经系统受累在子痫前期病理生理学中的核心作用，本研究旨在评估子痫前期孕妇的母体血清神经丝氨酸蛋白酶抑制剂水平，并探讨其与疾病严重程度的关联。
设计
前瞻性病例对照研究。
地点
土耳其安卡拉的一家三级转诊中心。
研究对象
诊断为子痫前期的单胎孕妇（n = 44）和孕龄匹配的血压正常孕妇作为对照组（n = 44）。
方法
将参与者分为子痫前期组和对照组。使用酶联免疫吸附测定（ELISA）对血清神经丝氨酸蛋白酶抑制剂水平进行定量。根据子痫前期的临床严重程度进行亚组分析。统计分析包括组间比较、受试者工作特征（ROC）曲线分析和相关性检验。
主要观察指标
主要观察指标是母体血清神经丝氨酸蛋白酶抑制剂水平。次要观察指标包括产科和新生儿参数，如分娩时的孕周、分娩方式、新生儿重症监护病房（NICU）入院情况和阿氏评分。
结果
与对照组相比，子痫前期组的血清神经丝氨酸蛋白酶抑制剂水平显著降低（p = 0.018）。在子痫前期队列中，重症患者的神经丝氨酸蛋白酶抑制剂浓度甚至低于轻度子痫前期患者。ROC曲线分析确定，识别子痫前期的神经丝氨酸蛋白酶抑制剂临界值≤22.95 ng/mL（AUC：0.647，p = 0.013），识别重度子痫前期的临界值≤14.7 ng/mL（AUC：0.740，p = 0.007）。
结论
母体血清神经丝氨酸蛋白酶抑制剂水平降低与子痫前期的诊断和严重程度均相关。这些发现突出了神经丝氨酸蛋白酶抑制剂在该疾病炎症机制中的潜在作用，并支持其作为临床预测模型中候选生物标志物的效用。
临床试验注册
不适用。
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