妊娠期糖尿病孕妇外周血中Cfp-mRNA、Cff-DNA及VEGF、SFlt-1水平的变化趋势

Changes of Cfp-mRNA, Cff-DNA, VEGF and SFlt-1 levels in peripheral blood of pregnant women with gestational diabetes mellitus

目的 研究探讨妊娠期糖尿病孕妇外周血中无细胞胎盘信使RNA(cell-free placenta mRNA,Cfp-mRNA)、游 离胎盘DNA(cell-free fetal DNA,Cff-DNA)及血管内皮生长因子(vascular endothelial growth factor,VEGF)、可溶性受 体1(soluble receptor 1,SFlt-1)的水平变化趋势及临床表达意义。方法 选择2016年1月 2018年1月在我院进行产前检查的 妊娠期糖尿病孕妇110例(观察组)为研究对象,并根据检查胎儿的情况将观察组分为正常胎儿组49例、巨大胎儿组38例、胎 儿宫内生长受限组23例,并选择同期在我院进行产前检查的健康孕妇50例为对照组。采用聚合酶链式反应(PCR)扩增技术 检测2组孕妇在孕24周、孕30周、孕36周和分娩后1周2组的Cfp-mRNA、Cff-DNA,采用酶联免疫吸附实验(ELISA)检查2组孕 妇在孕24周、孕30周、孕36周和分娩后1周的VEGF、SFlt-1水平,并进行组间比较,分析探讨各项指标的变化采用Pearson相关性检 验对妊娠期糖尿病孕妇的Cfp-mRNA、Cff-DNA与VEGF、SFlt-1水平相关性进行分析探讨。结果 观察组在各阶段的Cfp-mRNA、 Cff-DNA、VEGF、SFlt-1均高于对照组,且胎儿宫内生长受限组高于巨大胎儿组,巨大胎儿组高于正常胎儿组(P<0.05)。经Pearson 检验分析,Cfp-mRNA、Cff-DNA与VEGF、SFlt-1呈正相关。结论 妊娠期糖尿病孕妇的Cfp-mRNA、Cff-DNA、VEGF、SFlt-1 均有显著升高,且各项指标的水平变化对胎儿的发育情况有影响,因此可通过对妊娠期糖尿病孕妇Cfp-mRNA、Cff-DNA、 VEGF、SFlt-1各项指标的监测,对于疾病的发生发展及婴儿结局的预测有重要意义。

Objective To investigate the changes and clinical significance of acellular placental messenger RNA(CfpmRNA),free placental DNA(Cff-DNA),vascular endothelial growth factor(VEGF)and soluble receptor 1(SFlt-1)in peripheral blood of pregnant women with gestational diabetes mellitus(GDM).Methods One hundred and ten pregnant women with gestational diabetes mellitus who underwent prenatal examination in our hospital between January 2016 and January 2018 were selected as the subjects.The observation group was divided into the normal fetus group(49 cases),macrosomia group(38 cases)and intrauterine growth restriction(FGR)group(23 cases)according to the results of fetal examination.Another 50 healthy pregnant women were selected as the control group.The levels of CFP-mRNA and Cff-DNA were detected by polymerase chain reaction(PCR)at 24 weeks of gestation,30 weeks of gestation,36 weeks of gestation and 1 week after delivery.The levels of VEGF and SFlt-1 were detected by enzyme-linked immunosorbent assay(ELISA)at 24 weeks of gestation,30 weeks of gestation,36 weeks of gestation and 1 week after delivery.Pearson correlation test was used to analyze the correlations between Cfp-mRNA,Cff-DNA,VEGF and SFlt-1 levels in gestational diabetes mellitus patients.Results The Cfp-mRNA,Cff-DNA,VEGF and SFlt-1 levels of the observation group were higher than those of the control group at each stage,and the FGR level was higher than that of the macrosomia group,and was the lowest in the normal fetus group(P<0.05).Pearson test and analysis showed that Cfp-mRNA and Cff-DNA were positively correlated with VEGF and SFlt-1.Conclusion The levels of Cfp-mRNA,Cff-DNA,VEGF and SFlt-1 in gestational diabetes mellitus patients are significantly elevated,and the changes of each index has effect on fetal development.Therefore,the monitoring of Cfp-mRNA,Cff-DNA,VEGF,SFlt-1 in gestational diabetes mellitus patients can be used to predcit the occurrence and development of the disease and the infant outcome.The prediction is of great significance.