孕早期UtA-PI、血清25-(OH)D_(3)及PLGF与子痫前期的关系分析

Analysis of the correlation between UtA-PI,serum 25-(OH)D3,PLGF and pre-eclampsia in early pregnancy

目的探讨孕早期子宫动脉搏动指数(UtA-PI)、血清25羟基维生素D3[25-(OH)D3]及胎盘生长因子(PLGF)与子痫前期(PE)的关系。方法90例定期产检并分娩的孕妇,根据PE发病情况分为对照组(未发生PE)、早发型PE组与晚发型PE组,每组30例。三组孕妇于孕11~13+6周超声监测子宫动脉血流参数并采血测定血清25-(OH)D3、PLGF水平。对比三组孕妇孕早期血清25-(OH)D3、PLGF水平及子宫动脉血流参数[UtA-PI、子宫动脉阻力指数(UtA-RI)及子宫动脉收缩期峰值流速与舒张期末血流速度比值(UtA-S/D)],分析血清25-(OH)D3、PLGF水平与子宫动脉血流参数的相关性。结果早发型PE组孕妇孕早期血清25-(OH)D3、PLGF分别为(22.59±4.07)nmol/L、(300.74±20.05)pg/ml,晚发型PE组分别为(16.82±3.14)nmol/L、(233.55±16.58)pg/ml,对照组分别为(31.22±4.16)nmol/L、(405.31±28.64)pg/ml,三组孕妇孕早期血清25-(OH)D3及PLGF水平对比差异具有统计学意义(P<0.05)。晚发型PE组、早发型PE组血清25-(OH)D3、PLGF水平低于对照组,晚发型PE组低于早发型PE组,差异具有统计学意义(P<0.05)。早发型PE组孕妇孕早期UtA-PI、UtA-RI及UtA-S/D分别为(1.14±0.15)、(1.18±0.15)、(3.45±0.28),晚发型PE组分别为(1.25±0.24)、(1.25±0.21)、(3.93±0.31),对照组分别为(0.95±0.11)、(0.95±0.11)、(3.18±0.22),三组孕妇孕早期UtA-PI、UtA-RI及UtA-S/D对比差异具有统计学意义(P<0.05)。晚发型PE组、早发型PE组UtA-PI、UtA-RI及UtA-S/D高于对照组,晚发型PE组高于早发型PE组,差异具有统计学意义(P<0.05)。Pearson相关分析显示:UtA-RI、UtA-PI、UtA-S/D与血清25-(OH)D3、PLGF均呈负相关(P<0.05)。结论孕早期UtA-PI、血清25-(OH)D3及PLGF与PE有密切联系,通过检测其水平变化,可以辅助PE的临床诊断。

Objective To discuss the correlation between uterine artery pulsation index(UtA-PI),serum 25-hydroxyvitamin D3[25-(OH)D3],placental growth factor(PLGF)and pre-eclampsia(PE)in early pregnancy.Methods A total of 90 pregnant women who had regular antenatal checkups and delivered were divided into a control group(no PE),an early-onset PE group and a late-onset PE group according to the incidence of PE,with 30 cases in each group.The uterine artery blood flow parameters were monitored by ultrasound and the levels of serum 25-(OH)D3 and PLGF were measured by blood sampling at 11-13+6 weeks of gestation.Serum 25-(OH)D3 and PLGF levels and uterine artery blood flow parameters[UtA-PI,uterine artery resistance index(UtA-RI)and uterine artery peak systolic to end-diastolic flow velocity(UtA-S/D)]were compared among the three groups of pregnant women in early pregnancy,and the correlation between serum 25-(OH)D3 and PLGF levels and uterine artery blood flow parameters was analyzed.Results Serum 25-(OH)D3 and PLGF in early pregnancy were(22.59±4.07)nmol/L and(300.74±20.05)pg/ml in the early-onset PE group,(16.82±3.14)nmol/L,(233.55±16.58)pg/ml in the late PE group,and(31.22±4.16)nmol/L,(405.31±28.64)pg/ml in the control group.The differences in serum 25-(OH)D3 and PLGF levels in early pregnancy among the three groups were statistically significant(P<0.05).Serum 25-(OH)D3 and PLGF in the late-onset PE group and early-onset PE group levels were lower than those in the control group,and the late-onset PE group was lower than the early-onset PE group.The differences were statistically significant(P<0.05).UtA-PI,UtA-RI,and UtA-S/D in early pregnancy were(1.14±0.15),(1.18±0.15),and(3.45±0.28)in the early-onset PE group,(1.25±0.24),(1.25±0.21),and(3.93±0.31)in the late-onset PE group,and(0.95±0.11),(0.95±0.11),and(3.18±0.22)in the control group.There were statistically significant differences in UtA-PI,UtA-RI and UtA-S/D among the three groups in early pregnancy(P<0.05).UtA-PI,UtA-RI and UtA-S/D in late-onset PE group and early-onset PE group were higher than those in the control group,while those in late-onset PE group were higher than those in early-onset PE group.The differences were statistically significant(P<0.05).Pearson correlation analysis showed that UtA-RI,UtA-PI and UtA-S/D were negatively correlated with serum 25-(OH)D3 and PLGF(P<0.05).Conclusion UtA-PI,serum 25-(OH)D3 and PLGF are closely correlated with PE in early pregnancy,and the change of their levels can assist the clinical diagnosis of PE.