孕期血清sVEGFR2、HPL、IGF-Ⅰ水平监测在预测胎儿生长受限中的作用

The role of monitoring serum sVEGFR2,HPL,and IGF-1 levels during pregnancy in pre-dicting fetal growth restriction

目的探讨孕期血清水溶性血管内皮生长因子受体2(sVEGFR2)、人胎盘泌乳素(HPL)、胰岛素样生长因子-1(IGF-Ⅰ)水平监测在预测胎儿生长受限(FGR)中的作用。方法选取2020年10月至2022年10月在郑州市妇幼保健院经临床检查疑胎儿生长受限并住院分娩的110例产妇作为研究对象,纳入为观察组,选取同期正常妊娠110例产妇作为对照组,比较两组血清sVEGFR2、HPL、IGF-Ⅰ水平,根据新生儿体质量将疑FGR产妇分为FGR组(98例)及非FGR组(12例),分析sVEGFR2、HPL、IGF-Ⅰ单独及联合检测对FGR的诊断价值。结果对照组产妇孕中、晚期血清sVEGFR2、HPL、IGF-Ⅰ水平均高于观察组,差异有统计学意义(t=28.457,28.902,24.076,26.234,30.474,25.908,P<0.05);FGR组羊水指数、白蛋白、雌三醇、sVEGFR2、HPL、IGF-Ⅰ均较非FGR组低,差异有统计学意义(t=11.672,6.159,16.459,29.335,26.600,39.433,P<0.05);Logistic多因素回归分析结果显示,羊水指数、白蛋白、雌三醇、sVEGFR2、HPL、IGF-Ⅰ为FGR的独立影响因素(P<0.05);ROC曲线分析结果显示,sVEGFR2、HPL、IGF-Ⅰ三者单独及联合诊断曲线下面积(AUC)分别为0.798、0.845、0.812、0.955,联合检测优于单一检测(P<0.05)。结论FGR产妇孕期血清sVEGFR2、HPL、IGF-Ⅰ较正常妊娠产妇低,三者联合检测对FGR具有较高的诊断效能。

Objective To investigate the role of serum water-soluble vascular endothelial growth factor receptor 2(sVEGFR2),human placental prolactin(HPL)and insulin-like growth factor-1(IGF-1)in predicting fetal growth restriction(FGR)during pregnancy.Methods From October 2020 to October 2022,110 pregnant women with suspected fetal growth restriction and hospitalized delivery in Zhengzhou Maternal and Child Health Hospital were selected as the study objects and included as the observation group,and 110 pregnant women with normal pregnancy during the same period were selected as the control group.Serum levels of sVEGFR2,HPL and IGF-1 were compared between the two groups.According to neonatal body mass score,the pregnant women suspected of FGR were divided into the FGR group(98 cases)and the non-FGR group(12 cases).The diagnostic value of sVEGFR2,HPL and IGF-1 alone and combined in FGR was analyzed.Results The levels of serum sVEGFR2,HPL and IGF-1 in the middle and late pregnancy in the control group were higher than those in the observation group,and the differences were statistically significant(t=28.457,28.902,24.076,26.234,30.474,25.908,P<0.05).Amniotic fluid index,albumin,estriol,sVEGFR2,HPL,IGF-1 in the FGR group were lower than those in the non-FGR group,and the differences were statistically significant(t=11.672,6.159,16.459,29.335,26.600,39.433,P<0.05).Logistic multivariate regression analysis showed that amniotic fluid index,smoking history,albumin,estriol,sVEGFR2,HPL and IGF-1 were independent influencing factors of FGR(P<0.05).The ROC curve analysis results showed that the area under the curve(AUC)of sVEGFR2,HPL and IGF-1 alone and combined were 0.798,0.845,0.812 and 0.955,respectively.Combined detection was superior to single detection(P<0.05).Conclusion The serum levels of sVEGFR2,HPL and IGF-1 in pregnant women with FGR are lower than those in normal pregnant women.sVEG-FR2,HPL and IGF-1 are independent influencing factors of FGR,and the combined detection of these three factors has high diagnostic efficacy for FGR.