孕妇血浆胎盘生长因子与死胎、子痫前期等妊娠结局的相关性研究

Correlation of plasma placental growth factor with pregnant outcome

目的：分析胎盘生长因子（PLGF）／可溶性血管内皮生长因子受体-1（SVEGFR-1）和PLGF／可溶性内皮因子（SE）比值与妊娠不利结局的关系。方法：2011年1月～2012年12月期间采用前瞻性队列研究设计，于核工业四一六医院和成都市锦江区妇幼保健院产科门诊及住院部纳入孕16～22用意向经阴道分娩的孕妇734例。纳入人群在入组时留取血液标本进行分析，入组后每4周均进行一次体格检查和量表调查。血液标本离心后分析PI。GF、SVEGFR-1、SE含量及比值，用Logistic回归分析指标与妊娠不利结局的关系。结果：正常分娩孕妇486例，诊断为胎儿过小66例，子痫前期24例，发生死胎2例，其他不利结局156例。PLGF／SVEGFR—1指标诊断子痫前期、重度子痫前期、死胎的敏感性和特异性分别达到了60％、72％，72％、84％，8l％、95％；假阳性率控制在5％～14％。PLGF／SE指标诊断子痫前期、重度子痫前期、死胎的敏感性和特异性分别达到了62％、86％，78％、84％，60％、88％；假阳性率控制在11％～16％。结论：PLGF／SVEGFR-1和PLGF／SE比值可作为孕早中期预测妊娠不利结局的判断指标。

Objective. To analyze the relationship between PLGF/SVEGFR-1 and PLGF/SE and adverse birth outcomes. Methods. A total of 734 pregnant women with a gestational age of 16-22 weeks who intended to eutocia and were admitted from Jan 2011 to Dec 2012 were selected. Blood was collected at the start of this study, and physical examination and assessments were taken every 4 weeks. PLGF, SVEGFR-1, SE were determined and analyzed by Logistic regression analysis. Results： There were 486 cases with normal delivering, 66 cases with extreme fetus, 24 cases with preeclampsia, 2 with stillbirth and 156 with other complications. Sensitivity and specificity of PLGF/SVEGFR-1 for preeclampsia, severe preeclampsia and still birth were 60% and 72%, 72% and 84%, 81% and 95%, respectively; with a false positive rate from 5% to 14%. Sensitivity and specificity of PLGF/SE for preeclampsia, severe preeclamp- sia and still birth were 62% and 86%, 78% and 84%, 60% and 88%, respectively; with a false positive rate from 11% to 16%/4o. Conclusion： PLGF/SVEGFR-1 and PLGF/SE could be used as a predictive value for early diagnosis of adverse outcomes.