sFlt-1、PLGF及PAPP-A在子痫前期临床诊断及预后判断中的应用

Application of sFlt⁃1,PLGF and PAPP⁃A in clinical diagnosis and prognosis of preeclampsia

目的 研究可溶性血管内皮生长因子受体-1(sFlt-1)、胎盘生长因子(PLGF)及妊娠相关血浆蛋白-A(PAPP-A)在子痫前期临床诊断及预后判断中的应用效果。方法 选取2021年6月至2023年1月北京市大兴区人民医院收治的子痫前期孕妇151例为观察组,另选取同期进行孕检且结果正常的149名孕妇为对照组。比较两组孕妇sFlt-1、PLGF、PAPP-A水平;根据子痫前期严重程度不同将孕妇分为子痫前期轻度组和子痫前期重度组,比较子痫前期不同严重程度孕妇的sFlt-1、PLGF、PAPP-A水平;对比观察组患者不同妊娠结局一般资料、血清sFlt-1、PLGF、PAPP-A变化;进一步纳入多因素二元回归Logistic回归方程,分析影响子痫前期预后的危险因素。结果 观察组血清PLGF与PAPP-A水平均低于对照组,sFlt-1水平高于对照组,差异均有统计学意义(P<0.05);子痫前期轻度组95例、子痫前期重度组56例,子痫前期重度组PLGF与PAPP-A水平低于子痫前期轻度组,sFlt-1高于子痫前期轻度组,差异均有统计学意义(P<0.05);正常妊娠组117例,不良妊娠组34例,两组糖尿病史、高血压史、sFlt-1、PLGF、PAPP-A比较,差异具有统计学意义(P<0.05),两组年龄、BMI、孕周比较,差异无统计学意义(P>0.05);Logistic结果显示,有糖尿病史、有高血压史、sFlt-1水平升高、PAPP-A水平降低、PLGF水平降低是影响子痫前期患者预后的危险因素(P<0.05)。结论 子痫前期孕妇血清sFlt-1、PLGF、PAPP-A表达呈异常状态,三指标可用于子痫前期的早期诊断。

Objective To explore the application effect of soluble FMS-like tyrosine kinase 1(sFlt-1),placental growth factor(PLGF)and pregnancy associated plasma protein-A(PAPP-A)in the clini-cal diagnosis and prognosis of preeclampsia.Methods A total of 151 pregnant women with preeclampsia ad-mitted to Beijing Daxing District Peoples Hospital from June 2021 to January 2023 were selected as the obser-vation group,and 149 pregnant women who underwent pregnancy examination and had normal results during the same period were selected as the control group.The levels of sFlt-1,PLGF and PAPP-A were compared be-tween the two groups;according to the severity of pre eclampsia,pregnant women were divided into the mild pre eclampsia group and the severe pre eclampsia group,and the levels of sFlt-1,PLGF and PAPP-A of preg-nant women with different severity of preeclampsia were compared.The general data of different pregnancy outcomes,the changes of serum sFlt-1,PLGF and PAPP-A were compared in the observation group.Multivar-iate binary logistic regression equation was included to analyze the risk factors that affects the prognosis of pre-eclampsia.Results Serum PLGF and PAPP-A levels in the observation group were lower than those in the control group,and sFlt-1 levels were higher than those in the control group,with statistical significance(P<0.05).There were 95 cases in the mild pre eclampsia group and 56 cases in the severe eclampsia group,the PLGF and PAPP-A levels in the severe pre eclampsia group were lower than those in the mild pre eclampsia group,and sFlt-1 levels in the severe pre eclampsia group were higher than those in the mild pre eclampsia group,with statistical significance(P<0.05).There were 117 cases in the normal pregnancy group and 34 cas-es in the adverse pregnancy group,and there were statistically significant differences in the history of diabe-tes,hypertension,sFlt-1,PLGF and PAPP-A between the two groups(P<0.05),while there were no statisti-cally significant differences in age,BMI and gestational age between the two groups(P>0.05).Logistic re-sults showed that the history of diabetes,history of hypertension,increase of sFlt-1 level,decrease of PAPP-A level and decrease of PLGF level were risk factors affecting the prognosis of preeclampsia patients(P<0.05).Conclusion The expression of sFlt-1,PLGF and PAPP-A in the serum of pregnant women with pre-eclampsia is abnormal.These three markers can be used for the early diagnosis of preeclampsia.