血清sFT-1、PIGF对子痫前期患者妊娠结局的预测价值

The predictive value of serum sFT-1 and PIGF on pregnancy outcome in patients with preeclampsia

目的 探讨血清可溶性血管内皮生长因子受体1(sFlt-1)、胎盘生长因子(PIGF)水平对子痫前期(PE)患者妊娠结局的预测价值。方法 选取PE孕妇136例(其中轻度PE 94例,重度PE 42例)和健康孕妇100例(对照组),均行血清sFlt-1、PIGF检测,比较两组血清sFlt-1、PIGF水平差异。按是否发生不良妊娠结局,将PE产妇分为结局不良组(n=54)与结局良好组(n=82),比较不同妊娠结局组血清sFlt-1、PIGF水平差异,使用受试者工作特征(ROC)曲线评价sFlt-1、PIGF对不良妊娠结局的预测能力。结果 PE组与对照组比较,血清PIGF水平显著下降(P<0.05),sFlt-1增高(P<0.05);且重度PE组血清PIGF水平低于轻度PE组(P<0.05),sFlt-1高于轻度PE组(P<0.05)。与结局良好组比较,结局不良组收缩压、24 h尿蛋白定量及血清sFlt-1水平更高(P<0.05),PIGF水平更低(P<0.05)。Logistic回归模型分析得出,血清sFlt-1(OR=1.861)及PIGF(OR=0.654)均为PE产妇不良妊娠结局的独立影响因素(P<0.05)。ROC曲线分析显示,血清sFlt-1、PIGF预测不良妊娠结局的AUC分别为0.857、0.855。结论 血清sFlt-1、PIGF与PE的发生发展相关,且对PE孕妇不良妊娠结局有一定的预测价值。

Objective To investigate the predictive value of serum soluble vascular endothelial growth factor receptor 1(sFlt-1) and placental growth factor(PIGF) levels on pregnancy outcome in patients with preeclampsia.Methods 136 pregnant women with PE(94 cases of mild PE,42 cases of severe PE) and 100 healthy pregnant women(control group) were selected.Serum sFlt-1 and PIGF were detected, and the differences of serum sFlt-1 and PIGF levels between the two groups were compared.According to the occurrence of adverse pregnancy outcomes, PE women were divided into poor outcome group(n=54) and good outcome group(n=82).The differences of serum sFlt-1 and PIGF levels in different pregnancy outcome groups were compared.The receiver operating characteristic(ROC) curve was used to evaluate the predictive ability of sFlt-1 and PIGF for adverse pregnancy outcomes.Results Compared with the control group, the serum PIGF level in the PE group was significantly decreased(P<0.05),and sFlt-1 was increased(P<0.05).The serum PIGF level in the severe PE group was lower than that in the mild PE group(P<0.05),and the sFlt-1 was higher than that in the mild PE group(P<0.05).Compared with the good outcome group, the systolic blood pressure, 24 h urine protein quantification and serum sFlt-1 level were higher in the poor outcome group(P<0.05),and the PIGF level was lower(P<0.05).Logistic regression model analysis showed that serum sFlt-1(OR=1.861) and PIGF(OR=0.654) were independent influencing factors of adverse pregnancy outcomes in PE women(P<0.05).ROC curve analysis showed that the AUC of serum sFlt-1 and PIGF in predicting adverse pregnancy outcomes were 0.857 and 0.855,respectively.Conclusion Serum sFlt-1 and PIGF are related to the occurrence and development of PE,and have certain predictive value for adverse pregnancy outcomes of PE pregnant women.