血清sFlt-1、PLGF水平及比值变化预测孕妇轻度子痫前期发病的Meta分析

Meta-analysis of the relationship between the serum levels of sFlt-1, PLGF and their ratio for diagnosis of mild preeclampsia in pregnant women

目的 :探讨血清可溶性血管内皮生长因子受体-1(soluble fms-like tyrosine kinase-1,s Flt-1)、胎盘生长因子(placental growth factor,PLGF)水平及比值变化与轻度子痫前期发病关系。方法 :检索万方、CNKI、Pub Med、Embase和Cochrane收集1994—2016年国内外公开发表的关于血清s Flt-1、PLGF水平及比值变化与轻度子痫前期关系的中英文病例对照研究,剔除不符合标准的文献,对纳入的文章采用Review Manager 5.3软件对结果进行统计分析。结果:共纳入文献17篇,其中中文文献14篇,英文文献3篇。血清s Flt-1表达水平与轻度子痫前期的关系的异质性检验I^2=96%,P<0.000 01,存在明显的异质性,合并效应SMD=4.89(95%CI:3.60~6.17),P<0.000 01,差异有统计学意义。血清PLGF表达水平与轻度子痫前期的关系的异质性检验I^2=93%,P<0.000 01,存在明显的异质性,合并效应SMD=-2.32(95%CI:-2.91^-1.72),P<0.000 01,差异有统计学意义。轻度子痫前期组和正常对照组血清s Flt-1/PLGF比值异质性检验I^2=98%,P<0.000 01,合并效应SMD=1.95(95%CI:0.50~3.40),P<0.000 01,差异有统计学意义。结论:PLGF与轻度子痫前期的发病具有密切关系,血清s Flt-1的表达水平与轻度子痫前期有关,s Flt-1以及s Flt-1/PLGF比值可以作为辅助诊断轻度子痫前期的有效指标。

Objective：To investigate the relationship between the serum levels of s Flt-1,PLGF and their ratio in mild preeclampsia.Methods：We searched Wanfang,CNKI,Pub Med,Embase and Cochran,and published domestic and foreign controlled studies about the relationship between the serum levels of s Flt-1,PLGF and their ratio in mild preeclampsia from 1994 to 2014. Then,we excluded non-compliant documents,and statistically analyzed the results of included studies using Review Manager 5.3 software. Results：A total of 17 studies were included in this study,including 14 Chinese studies and 3 English studies. Heterogeneity test about the serum levels of s Flt-1 expression and the relationship between mild preeclampsia was I2=96%,P〈0.000 01,and the heterogeneity was significant. The combined effect of SMD =4.89（95% CI：3.60 ～6.17）,P〈0.000 01,the difference was statistically significant.Heterogeneity test about the serum levels of PLGF expression and the relationship between mild preeclampsia was I～2=93%,P〈0.000 01,the heterogeneity was significant. The combined effect of SMD=-2.32（95%CI：-2.91～-1.72）,P〈0.000 01,the difference was statistically significant. Heterogeneity test about the serum levels of s Flt-1 / PLGF ratio expression and the relationship between preeclampsia was I2=98%,P〈0.000 01,the heterogeneity was significant,the combined effect of SMD=1.95（95%CI：0.50～3.40）,P〈0.000 01,the difference was statistically significant. Conclusion：PLGF is highly correlated with the occurrence and development of mild preeclampsia;the serum levels of s Flt-1 expression associated with mild preeclampsia;s Flt-1 and s Flt-1 / PLGF ratio can be used as an effective index for diagnosis of mild preeclampsia.