重度子痫前期孕妇血清sFlt-1及补体C1q、C5a水平变化与围生儿结局的关系研究

Relationship between serum sFlt-1, C1q and C5a levelsand perinatal outcomes in pregnant women with severe preeclampsia

目的探讨重度子痫前期患者不同发病时间血清可溶性血管内皮生长因子受体-1(sFlt-1)及补体C1q、C5a水平变化与围生儿结局的关系。方法60例重度子痫前期孕妇作为研究组(早发型、晚发型重度子痫前期各30例),于入院时未予药物治疗情况下采血。正常妊娠孕妇30例为对照组,分别于孕34周前及足月待产时采血。各组孕妇均记录围产儿结局。采用酶联免疫法(ELISA)检测各组孕妇血清sFlt-1及补体C5a水平。免疫透射比浊法测定血清C1q水平。结果与对照组相比,研究组血清sFlt-1、C5a水平明显升高,而血清C1q水平显著降低(P<0.05);早发型重度子痫前期孕妇血清sFlt-1、C5a水平较晚发型重度子痫前期孕妇升高,血清C1q水平较晚发型重度子痫前期降低(P<0.05);重度子痫前期孕妇血清中sFlt-1、C5a水平与胎儿不良结局发生率呈正相关,血清C1q水平与胎儿不良结局发生率呈负相关(P<0.05)。结论重度子痫前期孕妇血清sFlt-1、C5a水平呈明显高表达,而血清C1q水平呈低表达,其水平变化与子痫前期严重程度及胎儿不良结局有明显相关性,说明补体系统异常激活可能与重度子痫前期的发病有关。

Objective To investigate the relationship between serum soluble fms-like tyrosine kinase receptor 1(sFlt-1),complements C1q and C5a levels and perinatal outcomes in patients with severe preeclampsia at different onset times.Methods A total of 60 pregnant women with severe preeclampsia were selected as a research group,including 30 early onset cases and 30 late onset cases of severe preeclampsia.Blood samples were collected on admission without drug treatment.Meanwhile,30 normal pregnant women were selected as a control group.Blood samples were collected at 34 weeks pregnant and before full-term delivery.Perinatal outcomes were recorded in all groups.The levels of serum sFlt-1 and C5a in pregnant women in each group were detected by ELISA.The level of serum C1q was determined by immunity transmission turbidity.Results Compared with the control group,the research group produced remarkably increased levels of serum sFlt-1 and C5a and decreased levels of serum C1q(P<0.05).The levels of serum sFlt-1 and C5a increased but the levels of serum C1q decreased in severe preeclampsia pregnant women with early onset,compared with those with late onset(P<0.05).The levels of serum sFlt-1 and C5a were positively correlated with the incidence of fetal adverse outcomes in pregnant women with severe preeclampsia,while the levels of serum C1q were negatively correlated with the incidence of fetal adverse outcomes(P<0.05).Conclusions For pregnant women with severe preeclampsia,their serum sFlt-1 and C5 are highly expressed but serum C1q are lowly expressed.Their changes are obviously associated with preeclampsia severity and fetal adverse outcomes.It indicate that abnormal activation of the complement system may be associated with the onset of severe preeclampsia.