现代妇产科进展2025，Vol.34Issue(11)：830-834,839,6.DOI:10.13283/j.cnki.xdfckjz.2025.11.002
妊娠期高血压患者PECAM-1、Fibulin-3水平与早期心肌损伤的关系及预测价值
Relationship and predictive value of PECAM-1 and Fibulin-3 levels and early myocardial injury in patients with hypertension during pregnancy
摘要
Abstract
Objective:The relationship between the changes of platelet endothelial cell adhesion molecule-1(PECAM-1)and fibrinogen-3(Fibulin-3)levels in patients with gesta-tional hypertension and the occurrence of early myocardial injury and its predictive value were analyzed.Method:A retrospective study was conducted to select 225 patients with gestational hypertension admitted to the hospital from March 2023 to March 2025 as the non-myocardial in-jury group.A total of 225 patients with gestational hypertension complicated with early myocar-dial injury admitted to the hospital during the same period were selected as the myocardial inju-ry group.According to the severity of the disease,the patients were divided into gestational hy-pertension group(199 cases,44.22%),preeclampsia group(146 cases,32.44%)and severe preeclampsia group(105 cases,23.33%).The general data of the two groups were compared.The levels of PECAM-1 and Fibulin-3 in patients with different severity were compared.The levels of PECAM-1 and Fibulin-3 were compared between the non-myocardial injury group and the myocardial injury group.Logistic regression was used to test the influence of various factors on the occurrence of early myocardial injury in patients with gestational hypertension.The no-mogram model of early myocardial injury in patients with gestational hypertension was construc-ted by R4.1.3 language"rms"package.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of PECAM-1 and Fibulin-3 levels for early myocardial in-jury in patients with gestational hypertension.Result:The age,CK-MB,cTnI and BNP in the myocardial injury group were higher than those in the non-myocardial injury group,and the pro-portion of patients with family history of gestational hypertension,preeclampsia and severe pre-eclampsia was higher than that in the non-myocardial injury group(P<0.05).The levels of PE-CAM-1 and Fibulin-3 in pregnancy-induced hypertension group,preeclampsia group and severe preeclampsia group decreased in turn(P<0.05).PECAM-1 and Fibulin-3 in the myocardial in-jury group were lower than those in the non-myocardial injury group(P<0.05).Logistic regres-sion analysis showed that older age,family history of gestational hypertension,preeclampsia,se-vere preeclampsia,and high expressions of CK-MB,cTnI,and BNP were risk factors for early myocardial injury in patients with gestational hypertension(OR>1,P<0.05).The high expres-sions of PECAM-1 and Fibulin-3 were a protective factor(OR<1,P<0.05).The Bootstrap in-ternal validation method was used to verify the model,and the C-index value was 0.781.The ROC curve showed that the AUCs of PECAM-1 and Fibulin-3 alone and in combination for pre-dicting early myocardial injury in patients with gestational hypertension were 0.704,0.714,and 0.781,respectively.The 95%CI were 0.657～0.752,0.666～0.761,and 0.739～0.822,re-spectively.The specificity was 0.609,0.627,and 0.769,respectively.The sensitivity was 0.729,0.733,and 0.649,respectively,and the Youden index was 0.338,0.360,and 0.418,respectively.Conclusion:The levels of PECAM-1 and Fibulin-3 decreased with the severity of gestational hypertension,which were the influencing factors of early myocardial injury in pa-tients with gestational hypertension.The combined detection of PECAM-1 and Fibulin-3 had a certain predictive effect on the occurrence of early myocardial injury.关键词
妊娠期高血压/心肌损伤/血小板内皮细胞黏附分子-1/纤维蛋白3/预测价值Key words
Hypertension during pregnancy/Myocardial injury/Platelet endothelial cell adhesion molecule-1/Fibrin 3/Predictive value分类
临床医学引用本文复制引用
李冉红,王莉,陈睿,刘侃,陈秀丽,武海英..妊娠期高血压患者PECAM-1、Fibulin-3水平与早期心肌损伤的关系及预测价值[J].现代妇产科进展,2025,34(11):830-834,839,6.基金项目
2024年度河南省医学科技攻关计划省部共建重点项目(No:SBGJ202402002) （No:SBGJ202402002）
