Serum endothelial cell specific molecules-1 level and its clinical significance in hypertensive disorders complicating pregnancy / 中国医师进修杂志

ABSTRACT

Objective:To investigate the serum endothelial cell specific molecule-1 (ESM-1) level and its clinical significance in patients with hypertensive disorders complicating pregnancy (HDCP).Methods:Three hundred pregnant women with HDCP (HDCP group) and 300 pregnant women undergoing health check-ups (healthy control group) from January to December 2019 in Maternity and Child Health Hospital of Wenling City of Zhejiang Province were selected. In HDCP group, hypertension during pregnancy was in 94 cases, mild preeclampsia was in 131 cases, and severe preeclampsia was in 75 cases. The serum ESM-1, serum uric acid and 24-hour urine protein levels were detected. The incidences of neonatal asphyxia, fetal distress, cesarean section, polyhydramnios, premature rupture of membranes and postpartum hemorrhage in the HDCP group were recorded.Results:The serum ESM-1, serum uric acid and 24-hour urine protein in HDCP group were significantly higher than those in healthy control group (0.42 ± 0.05) μg/L vs. (0.33 ± 0.04) μg/L, (262.34 ± 23.18) mmol/L vs. (212.37 ± 22.16) mmol/L and (0.36 ± 0.07) g vs. (0.11 ± 0.03) g, and the differences were statistical significant ( P<0.01). The correlation analysis results showed that the serum ESM-1 was positive correlation with serum uric acid and 24-hour urine protein in HDCP pregnant women ( r = 0.497 and 0.512, P<0.01). The serum ESM-1 in pregnant women with mild preeclampsia and severe preeclampsia were significantly higher than that in pregnant women with hypertension during pregnancy (0.44 ± 0.05) and (0.51 ± 0.06) μg/L vs. (0.38 ± 0.04) μg/L, the serum ESM-1 in pregnant women with severe preeclampsia was significantly higher than that in pregnant women with mild preeclampsia, and the differences were statistical significant ( P<0.05). With the median serum ESM-1 (0.41 μg/L) as the boundary, pregnant women with HDCP were divided into high ESM-1 group (154 cases) and low ESM-1 group (146 cases). The incidences of neonatal asphyxia, fetal distress, cesarean section, polyhydramnios, premature rupture of membranes and postpartum hemorrhage in high ESM-1 group were significantly higher than those in low ESM-1 group 14.94% (23/154) vs. 6.16% (9/146), 26.62% (41/154) vs. 9.59% (14/146), 46.10% (71/154) vs. 29.45% (43/146), 25.32% (39/154) vs. 3.42% (5/146), 23.38% (36/154) vs. 4.11% (6/146) and 20.13% (31/154) vs. 7.53% (11/146), and the differences were statistical significant ( P<0.01). Conclusions:Serum ESM-1 level is elevated in pregnant women with HDCP . Serum ESM-1 level is closely related to the severity of HDCP and pregnancy outcomes.