低分子肝素钙对早发型重度子痫前期患者后血清sFlt-1及PAPP-A表达水平影响

Effect of Low Molecular Weight Heparin Calcium on the Expression Levels of Serum sFlt-1 and PAPP-A in Early-Onset Severe Preeclampsia Patients

目的:通过检测早发型重度子痫前期患者可溶性fms样酪氨酸激酶1(sFlt-1)、妊娠相关血浆蛋白(PAPP-A)表达水平,探讨尼卡地平联合低分子肝素钙治疗作用机制。方法:选择2021年4月至2022年4月承德市妇幼保健院接收孕26~34周早发型重度子痫前期孕妇64例,且入选孕妇主动要求阴道分娩。按随机数字法分为研究组与对照组,各32例。对照组给予尼卡地平治疗,研究组给予尼卡地平结合低分子肝素钙治疗,采集治疗前、治疗1周时患者外周血,用酶联免疫吸附实验(ELISA)检测血清sFlt-1、胎盘生长因子(PLGF)、妊娠相关血浆蛋白;检测外周血血常规和肾功能等指标;记录孕妇平均分娩孕周时间。结果:治疗前,两组孕妇的sFlt-1、PLGF、PAPP-A、红细胞压积(PCV)和肌酐(Cr)、尿素氮(BUN)水平差异无统计学差异(P>0.05);与治疗前比较,两组孕妇治疗后血液sFlt-1、PCV和Cr、BUN水平降低,PLGF、PAPP-A上升,有统计学差异(P<0.05);与对照组比较,研究组sFlt-1、PCV与Cr、BUN水平降低,PLGF、PAPP-A水平升高,有统计学差异(P<0.05);研究组平均分娩孕周时间显著大于对照组,有统计学差异(P<0.05)。结论:尼卡地平联合低分子肝素钙,有助于胎盘功能恢复,改善肾功能,延缓病情进展,可优化妊娠指标,延长孕周,有效治疗早发型重度子痫前期患者。

Objective:To explore the therapeutic mechanism of Nicardipine combined with low molecular weight heparin calcium by detecting the expression levels of soluble fms-like tyrosine kinase 1(sFlt-1)and pregnancy-associated plasma protein-A(PAPP-A)in patients with early-onset severe preeclampsia.Methods:Sixty-four pregnant women with early-onset severe preeclampsia,voluntarily opting for vaginal delivery,were selected from Chengde Maternal and Child Health Hospital between April 2021 and April 2022,with gestational age ranging from 26 to 34 weeks.The patients were randomly divided into a study group and a control group,with 32 cases in each group.The control group received Nicardipine treatment,while the study group received a combination of Nicardipine and low molecular weight heparin calcium.Peripheral blood samples were collected before treatment and at 1 week of treatment.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum levels of sFlt-1,placental growth factor(PLGF),and PAPP-A.Peripheral blood routine and renal function were also examined.The average gestational age at delivery was recorded.Results:Before treatment,there were no significant differences in the levels of sFlt-1,PLGF,PAPPA,packed cell volume(PCV),creatinine(Cr),and blood urea nitrogen(BUN)between the two groups(P>0.05).Compared with pre-treatment levels,after treatment,both groups showed a decrease in sFlt-1,PCV,Cr,and BUN levels,and an increase in PLGF and PAPP-A levels,with statistically significant differences(P<0.05).When comparing the study group with the control group after treatment,the study group exhibited a significant decrease in sFlt-1,PCV,Cr,and BUN levels,and a significant increase in PLGF and PAPP-A levels(P<0.05).The average gestational age at delivery in the study group was significantly higher than that in the control group,with a statistically significant difference(P<0.05).Conclusion:Nicardipine combined with low molecular weight heparin calcium contributes to the recovery of placental function,improves renal function,delays disease progression,optimizes pregnancy indicators,prolongs gestational weeks,and effectively treats patients with early-onset severe preeclampsia.