血清可溶性fms样酪氨酸激酶-1水平与子痫前期患者子宫动脉血流参数的相关性

Correlation Between Serum Soluble fms-Like Tyrosine Kinase-1 Level and Uterine Artery Blood Flow Parameters in Patients with Preeclampsia

目的探讨子痫前期患者血清可溶性fms样酪氨酸激酶-1(sFlt-1)水平与子宫动脉血流参数的相关性。方法选取2019年7月至2021年7月于叶县人民医院就诊的128例子痫前期患者作为研究组,根据子痫前期患者病情程度分为3组,即轻度组(48例)、中度组(46例)、重度组(34例)。另选取55例同期健康体检孕妇作为参照组。比较两组及不同病情程度患者的血清血管内皮生长因子(VEGF)、sFlt-1及子宫动脉血流参数,包括子宫螺旋动脉搏动指数(PI)、收缩阻力指数(RI)、舒张末期最大血流速度(S/D),分析其相关性及血清VEGF、sFlt-1、子宫动脉血流参数对重度子痫前期的诊断价值。结果与参照组比较,研究组血清VEGF、S/D水平较低,血清sFlt-1、PI、RI较高(P<0.05)。3组血清VEGF、sFlt-1、PI、S/D、RI比较,差异有统计学意义(P<0.05);与轻度组、中度组相比,重度组VEGF、S/D水平较低,sFlt-1、PI、RI较高(P<0.05);与轻度组相比,中度组VEGF、S/D水平较低,sFlt-1、PI、RI较高(P<0.05)。血清VEGF水平与S/D呈正相关,与PI、RI呈负相关(P<0.05);血清sFlt-1水平与S/D呈负相关,与PI、RI呈正相关(P<0.05);血清VEGF水平与病情程度呈负相关,血清sFlt-1水平与病情程度呈正相关(P<0.05)。与血清VEGF、sFlt-1、PI、S/D、RI对应的曲线下面积(AUC)值比较,联合诊断的AUC较大(P<0.05)。结论血清VEGF、sFlt-1水平与子痫前期患者的子宫动脉血流参数具有相关性。临床可通过监测其水平评估病情程度,以制定相应的治疗方案。

Objective To investigate the correlation between serum soluble fms-like tyrosine kinase-1(sFlt-1)level and uterine artery blood flow parameters in patients with preeclampsia.Methods A total of 128 patients with preeclampsia who were treated in Yexian People’s Hospital from July 2019 to July 2021 were selected as research group.The patients with preeclampsia were divided into 3 groups according to the degree of disease,namely mild group(48 cases),moderate group(46 cases)and severe group(34 cases).Another 55 healthy pregnant women during the same period were selected as reference group.Serum vascular endothelial growth factor(VEGF),sFlt-1 and uterine artery blood flow parameters,including uterine spiral artery pulsatility index(PI),contraction resistance index(RI),maximum end-diastolic blood flow velocity(S/D),their correlation and the diagnostic value of serum VEGF,sFlt-1 and uterine artery blood flow parameters in severe preeclampsia were analyzed.Results Compared with reference group,the serum levels of VEGF and S/D in research group were lower,and the serum sFlt-1,PI and RI were higher(P<0.05).There were differences in serum VEGF,sFlt-1,PI,S/D and RI among the three groups(P<0.05).Compared with mild group and moderate group,the severe group had lower levels of VEGF and S/D,sFlt-1,and higher PI and RI(P<0.05).Compared with mild group,the moderate group had lower levels of VEGF and S/D,and higher sFlt-1,PI and RI(P<0.05).Serum VEGF level was positively correlated with S/D,and negatively correlated with PI and RI(P<0.05).Serum sFlt-1 level was negatively correlated with S/D,and positively correlated with PI and RI(P<0.05).Serum VEGF level was negatively correlated with disease severity,and serum sFlt-1 level was positively correlated with disease severity(P<0.05).Compared with the corresponding area under curve(AUC)values of serum VEGF,sFlt-1,PI,S/D and RI,the AUC of combined diagnosis was larger(P<0.05).Conclusion Serum VEGF and sFlt-1 levels are correlated with uterine artery blood flow parameters in patients with preeclampsia.Clinically,the severity of the disease can be assessed by monitoring its level to formulate corresponding treatment plans.