早发子痫前期患者血浆胎盘生长因子水平与围生结局的研究

The Study on Maternal Plasma Placental Growth Factor Level and the Perinatal Outcome in Early-Onset Pre-Eclampsia Patients

目的:探讨早发型子痫前期(EOPE)患者血浆胎盘生长因子(PlGF)水平与围生结局的关系。方法:纳入经剖宫产终止妊娠的125例EOPE患者。双抗体夹心酶标免疫分析法(ELISA)检测分娩当日血浆PlGF水平,根据EOPE患者血浆PlGF水平分为:≤12 pg/ml为PlGF≤12 pg/ml组(n=64),>12 pg/ml为PlGF>12 pg/ml组(n=61);测定新生儿出生后1小时内外周动脉血血气分析及乳酸(LAC)水平。比较两组患者血常规及生化指标及与围生结局的关系。结果:(1)PlGF≤12 pg/ml组患者Hb、HCT、24小时尿蛋白定量、尿素氮(BUN)、肌酐(Cr)水平高于PlGF>12 pg/ml组(P<0.05);而白蛋白(ALB)水平低于PlGF>12 pg/ml组,差异均有统计学意义(P<0.05)。(2)PlGF≤12 pg/ml组分娩孕周小于PlGF>12 pg/ml组;而羊水过少、羊水粪染、小于胎龄儿(SGA)的比例均高于PlGF>12 pg/ml组,差异均有统计学意义(P<0.05)。(3)PlGF≤12 pg/ml组新生儿出生体质量、1分钟Apgar评分、pH值、血钙、碱剩余(BE)均低于PlGF>12 pg/ml组;而LAC水平高于PlGF>12 pg/ml组;新生儿入住NICU的天数多于PlGF>12 pg/ml组,差异均有统计学意义(P<0.05)。结论:EOPE患者PlGF测定对于预测围生结局具有一定临床价值,PlGF≤12 pg/ml的高危EOPE患者发生肾功能受损明显增加,羊水过少、羊水粪染、SGA及新生儿窒息比例增加,且新生儿更易发生酸碱失衡及物质代谢紊乱,临床需要加强关注。

Objective： To investigate the relationship between plasma placental growth factor（PIGF） levels and perinatal outcomes in patients with early onset preeclampsia（EOPE）. Methods.125 patients with EOPE un- dergoing cesarean section were enrolled in this study. Enzyme-linked immunosorbent assay（ELISA） was used to detect the level of maternal plasma PIGF. According to the plasma PIGF level, ≤ 12 pg/ml was divided into PI- GF≤12 pg/ml group（ n =64） and PIGF 〉 12 pg/ml was in PIGF 〉 12 pg/ml group（ n =61 ）. The blood gas analysis and the level of lactic acid（, LAC） were measured within 1 hour after fetal birth. The routine and biochemical indexes of two groups and their relation with perinatal outcomes were compared. Results：①ln PIGF ≤ 12 pg/ml EOPE group, the Hb, HCT,24h urine protein level, BUN and Cr levels were higher than those in PIGF 〉 12 pg/ml group （ P 〈 0.05）. While the ALB level was lower than that of PIG F 〉 12 pg/ml group （ P 〈 0.05 ）, ②The gestational age of PIGF≤12 pg/ml group was less than that of PIGF 〉 12 pg/ml group,but the proportion of oligohydram- nios,meconium stained amniotic fluid and less than gestational age infants（SGA） were all higher than those of PIGF 〉12 pg/ml group（P〈0.05）. ③In the PIGF≤12 pg/ml group,neonatal birth weight（BW） ,1 minute Apgar score,pH,serum Ca,BE were all lower than those in PIGF 〉12 pg/ml group. But the level of LAC and the NICU hospital stay were all higher than those in PIGF 〉 12 pg/ml group （ P 〈 0. 05）. Conclusions：In EOPE patients, plasma PIGF level has certain clinical value in predicting perinatal outcome. If PIGF is ≤ 12 pg/ml,the maternal renal dysfunction may be more obviously,and there is higher incidence of oligohydramnios, meconium stained flu- id, SGA and neonatal asphyxia, and the newborn is more susceptible to metabolic imbalance and acid-base disorders, Mother and child care should be strengthened.