血清中可溶性fms样酪氨酸激酶-1和胎盘生长因子与子痫前期严重程度的相关性

Correlation of Soluble fms-like Tyrosine Kinase-1 and Placental Growth Factor with Severity of Preeclampsia

目的分析血清中可溶性fms样酪氨酸激酶-1(sFlt-1)和胎盘生长因子(PLGF)与子痫前期严重程度的相关性。方法选取2018年4月至2019年5月就诊于首都医科大学附属北京妇产医院诊断为子痫前期的40例单胎妊娠孕妇作为子痫前期组,选取同期30例健康妊娠孕妇作为正常对照组。采用电化学发光免疫分析法检测血清中的sFlt-1与PLGF水平,受试者工作特征曲线(ROC曲线)分析sFlt-1与PLGF在监测子痫前期严重程度方面的临床应用价值。结果子痫前期组sFlt-1及sFlt-1/PLGF比值显著高于正常对照组[8.72(5.39,13.40)μg/L比1.50(1.23,1.84)μg/L、207.21(52.93,512.32)比5.88(2.48,11.24)](P<0.05),PLGF水平明显低于正常对照组[40.19(22.37,149.73)ng/L比293.45(168.78,490.90)ng/L](P<0.05)。早发型子痫前期组血清PLGF水平明显低于晚发型子痫前期组[26.31(14.95,75.96)ng/L比107.50(79.30,261.50)ng/L],sFlt-1/PLGF比值明显高于晚发型子痫前期组[309.65(153.71,646.79)比53.51(31.19,93.79)](P<0.05)。血清PLGF水平与子痫前期发病时间呈正相关(r=0.549,P=0.012),sFlt-1/PLGF比值与发病时间呈负相关(r=-0.530,P=0.016)。ROC曲线分析显示,血清sFlt-1/PLGF比值的截断值为207.21时,ROC曲线下面积为0.833(95%CI 0.646~1.000),预测病情严重程度的灵敏度为71.40%,特异度为100.00%。结论sFlt-1和PLGF可作为监测子痫严重程度的新型血清标志物。

Objective To analyze the correlation of soluble fms-like tyrosine kinase-1(sFlt-1)and placental growth factor(PLGF)with the severity of preeclampsia.Methods A total of 40 singleton pregnant women diagnosed with preeclampsia in the Beijing Obstetrics and Gynecology Hospital,Capital Medical University from Apr.2018 to May 2019 were included as a preeclampsia group,and 30 healthy pregnant women during the same period were included as a normal control group.The electrochemiluminescence immunoassay method was used to detect the levels of sFlt-1 and PLGF in the serum,and the receiver operating characteristic curve(ROC curve)was used to analyze the clinical application value of sFlt-1 and PLGF in monitoring the severity of preeclampsia.Results The sFlt-1 concentration and the sFlt-1/PLGF ratio in the preeclampsia group were significantly higher than those in the control group[8.72(5.39,13.40)μg/L vs 1.50(1.23,1.84)μg/L,207.21(52.93,512.32)vs 5.88(2.48,11.24)](P<0.05);PLGF level was significantly lower than that of the normal control group[40.19(22.37,149.73)ng/L vs 293.45(168.78,490.90)ng/L](P<0.05).The serum PLGF level of the early-onset preeclampsia group was significantly lower than that of the late-onset preeclampsia group[26.31(14.95,75.96)ng/L vs 107.50(79.30,261.50)ng/L],and the sFlt-1/PLGF ratio was significantly higher that of the late-onset preeclampsia group[309.65(153.71,646.79)vs 53.51(31.19,93.79)](P<0.05).The serum PLGF level was positively correlated with the onset time of preeclampsia(r=0.549,P=0.012).The ratio of sFlt-1/PLGF was negatively correlated with the onset time(r=-0.530,P=0.016).ROC curve analysis showed that when the cut-off value of the serum sFlt-1/PLGF vs was 207.21,the area under the ROC curve was 0.833(95%CI 0.646-1.000),the sensitivity of predicting the severity of the disease was 71.40%,and the specificity was 100.00%.Conclusion sFlt-1 and PLGF can be used as new serum markers for monitoring the severity of eclampsia.