子痫前期患者血清可溶性fms样酪氨酸激酶受体1水平与胎儿生长受限的相关性

Correlation Between Serum Soluble fms-like Tyrosine Kinase Receptor 1 Level and Fetal Growth Restriction in Patients with Preeclampsia

目的分析子痫前期患者血清可溶性fms样酪氨酸激酶受体1(sFlt-1)水平与胎儿生长受限(FGR)的相关性。方法选取2018年10月至2020年8月河南省人民医院豫东分院收治的30例发生FGR的孕晚期子痫前期患者作为FGR组,将同期收治的30例未发生FGR的孕晚期子痫前期患者作为非FGR组。所有患者均接受血清血管内皮生成因子(VEGF)、sFlt-1检测,并利用超声检查测定患儿生长指标(双顶径、股骨长度);分析子痫前期患者血清VEGF、sFlt-1水平与FGR的相关性,分析血清VEGF、sFlt-1、血压及尿蛋白水平对子痫前期患者发生FGR的影响;绘制受试者工作特征(ROC)曲线,分析血清VEGF、sFlt-1、血压及尿蛋白水平对子痫前期患者发生FGR的预测价值。结果FGR组收缩压、舒张压及尿蛋白水平高于非FGR组,差异有统计学意义(P<0.05)。FGR组血清sFlt-1水平高于非FGR组,血清VEGF、胎儿双顶径、股骨长度低于非FGR组,差异有统计学意义(P<0.05)。经双变量Pearson直线相关检验结果显示,子痫前期患者血清sFlt-1水平与血清VEGF水平、胎儿生长指标呈负相关(r<0,P<0.05),与舒张压、收缩压、尿蛋白水平呈正相关(r>0,P<0.05)。经logistic回归分析结果显示,舒张压高、尿蛋白高、血清sFlt-1高是子痫前期患者发生FGR的危险因素(OR>1,P<0.05)。绘制ROC曲线得到,血清VEGF、sFlt-1、血压及尿蛋白水平预测子痫前期患者发生FGR的曲线下面积(AUC)>0.7,具有较高的价值,且血清sF1t-1预测价值最高。结论子痫前期患者血清sFlt-1水平与血清VEGF、血压及尿蛋白及FGR密切相关,并可根据血清VEGF、sFlt-1、血压及尿蛋白水平预测FGR情况。

Objective To analyze the correlation between serum soluble fms-like tyrosine kinase receptor 1(sFlt-1)level and fetal growth restriction(FGR)in patients with preeclampsia.Methods The clinical data of 30 patients with preeclampsia in late pregnancy who had FGR in Yudong Branch of Henan Provincial People’s Hospital from October 2018 to August 2020 were retrospectively analyzed,included in FGR group.The clinical data of 30 cases patients with preeclampsia in late pregnancy who did not have FGR during the same period were included in the non FGR group.Serum vascular endothelial growth factor(VEGF)and sFlt-1 were detected in all patients,and the growth indexes(biparietal diameter,femur length)of children were measured by ultrasound.The correlations between serum VEGF,sFlt-1 levels and FGR of patients with preeclampsia were analyzed.The effects of serum VEGF,sFlt-1,blood pressure and urinary protein levels on FGR in patients with preeclampsia were analyzed.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum VEGF,sFlt-1,blood pressure and urinary protein levels for FGR in patients with preeclampsia.Results The levels of systolic blood pressure,diastolic blood pressure and urinary protein of patients in FGR group were higher than those in non FGR group(P<0.05).The serum sFlt-1 level of patients in FGR group was higher than that of non FGR group,and the serum VEGF,fetal biparietal diameter and femoral length were lower than those of non FGR group(P<0.05).The results of bivariate Pearson linear correlation test showed that serum sFlt-1 level was negatively correlated with serum VEGF level and fetal growth index in patients with preeclampsia(r<0,P<0.05),and it was positively correlated with diastolic blood pressure,systolic blood pressure and urinary protein level(r>0,P<0.05).The results of logistic regression analysis showed that high diastolic blood pressure,high urinary protein and high serum sFlt-1 were risk factors for FGR in patients with preeclampsia(OR>1,P<0.05).The ROC curve was drawn,the area under the curve(AUC)of serum VEGF,sFlt-1,blood pressure and urinary protein levels in predicting FGR in preeclampsia patients were>0.7,which had higher value,and serum sF1t-1 had the highest predictive value.Conclusion Serum sFlt-1 level is closely related to serum VEGF,blood pressure,urinary protein and FGR in patients with preeclampsia,and FGR can be predicted by serum VEGF,sFlt-1,blood pressure and urinary protein levels.