孕中期血清sFlt-1、PIGF和补体系统激活因子对子痫前期危险因素孕妇发生子痫前期的预测价值

Predictive value of serum sFlt-1,PIGF and omplement system activators for preeclampsia in the second trimester pregnant women with preeclampsia risk factors

目的评价孕中期可溶性胎盘血管内皮生长因子受体-1(sFlt-1)、胎盘生长因子(PIGF)、sFlt-1/PIGF比值及补体系统激活因子对子痫前期危险因素孕妇发生子痫前期的预测价值。方法采用病例对照研究。研究组包括165例至少具有一项子痫前期危险因素的孕妇,收集其孕20~26周之间的血清标本,采用酶联免疫吸附试验和免疫透射比浊法检测血清中的sFlt-1、PIGF、C3和B因子,计算s Flt-1/PIGF比值,绘制受试者工作特征(ROC)曲线。结果子痫前期患病组与未患病组相比,s Flt-1、sFlt-1/PIGF、C3、B因子显著升高(均P<0.01),PIGF水平降低(P<0.001)。s Flt-1、PIGF、sFlt-1/PIGF、C3和B因子的ROC曲线下面积分别为0.663、0.770、0.786、0.644、0.690,其中sFlt-1/PIGF的cut-off值为3.3(灵敏度85.7%,特异性77.0%)。结论子痫前期危险因素孕妇的外周循环中存在sFlt-1、PIGF、sFlt-1/PIGF变化和补体系统异常激活,对发生子痫前期有预测价值,且sFlt-1/PIGF表现最佳。

Objective To evaluate the predictive value of soluble placental vascular endothelial growth factor receptor-1(sFlt-1),placental growth factor(PIGF),sflt-1/PIGF ratio and complement system activation factor for preeclampsia risk factors in pregnant women.Methods A case-control study was conducted.The study group included 165 pregnant women with at least one preeclampsia risk factor.Serum samples were collected between 20 to 26 weeks of gestation.Serum sflt-1,PIGF,C3 and B factors were detected by Elisa and immunotransmission turbidimetry.Results sflt-1,sflt-1/PIGF,C3 and B factors were significantly increased in the preeclampsia group(all P<0.01)and decreased in the PIGF group(P<0.001).The areas under the ROC curve of sflt-1,PIGF,sflt-1/PIGF,C3,and B factor were 0.663,0.770,0.786,0.644,and 0.690,respectively.The cut-off value of sflt-1/PIGF was 3.3(sensitivity 85.7%,specificity 77.0%).Conclusion sFlt-1,PIGF,sflt-1/PIGF changes and abnormal complement system activation in the peripheral circulation have predictive value for the occurrence of preeclampsia in pregnant women with preeclampsia risk factors,and sflt-1/PIGF is the best index.