子痫前期孕妇血清PLGF、sFlt-1及激活素A的表达意义及母婴不良结局的影响因素分析

Significance of serum PLGF,sFlt-1 and activin A expression in pregnant women with preeclampsia and the influencing factors of maternal and infant adverse outcomes

目的 分析子痫前期孕妇血清胎盘生长因子(PLGF)、可溶性FMS样酪氨酸激酶1(sFlt-1)及激活素A的表达意义及母婴不良结局的影响因素。方法 选择自2021年1月至2023年11月宣城市中心医院接诊的100例子痫前期孕妇纳入观察组,另选100例正常妊娠孕妇纳入对照组。检测所有孕妇血清PLGF、sFlt-1及激活素A的水平,使用受试者工作特征曲线(ROC)分析血清PLGF、sFlt-1及激活素A对子痫前期的诊断效能,记录观察组子痫前期孕妇的母婴不良结局,使用单因素分析及多因素Logistic回归分析子痫前期孕妇母婴不良结局的影响因素。结果 观察组血清PLGF水平为(55.26±8.34) pg/mL,低于对照组[(86.12±15.08) pg/mL],sFlt-1及激活素A水平分别为(986.59±168.73)、(398.08±86.45) pg/mL,均高于对照组[(712.42±102.36)、(201.23±45.71) pg/mL],差异均有统计学意义(P<0.05)。重度子痫前期孕妇血清PLGF水平低于轻度子痫前期孕妇,sFlt-1及激活素A的水平均高于轻度子痫前期孕妇,差异均有统计学意义(P<0.05)。经Pearson相关性分析,子痫前期孕妇血清PLGF与尿蛋白呈负相关(P<0.05),与血小板计数呈正相关(P<0.05);子痫前期孕妇血清sFlt-1及激活素A与尿蛋白均呈正相关(P<0.05),与血小板计数均呈负相关(P<0.05)。血清PLGF、sFlt-1联合激活素A诊断子痫前期的敏感度为90.47%,特异度为51.64%、AUC为0.926。经单因素及多因素Logistic回归分析,产次、分娩孕周、白蛋白、PLGF、sFlt-1及激活素A均是子痫前期孕妇发生母婴不良结局的独立影响因素(P<0.05)。结论 血清PLGF、sFlt-1及激活素A与子痫前期发生及其严重程度有关,联合应用可提高对子痫前期的诊断效能,且均是母婴不良结局的独立影响因素。

Objective To analyze the expression significance of serum placental growth factor(PLGF),soluble FMS-like tyrosine kinase 1(sFlt-1)and activin A in pregnant women with preeclampsia,and the influencing factors of adverse maternal and infant outcomes.Methods A total of 100 pregnant women with preeclampsia admitted to Xuancheng City Central Hospital from January 2021 to November 2023 were included in the observation group,and another 100 pregnant women with normal pregnancy were included in the control group.The expression levels of serum PLGF,sFlt-1 and activin A in all pregnant women were detected.The diagnostic efficacy of serum PLGF,sFlt-1 and activin A for preeclampsia was analyzed using receiver operating characteristic(ROC)curve.The observation group of preeclampsia poor maternal and infant outcomes among pregnant women was recorded.The influencing factors of adverse maternal and infant outcomes in preeclampsia pregnant women were analyzed using univariate analysis and multivariate logistic regression analysis.Results The serum PLGF level in the observation group was(55.26±8.34)pg/mL,which was lower than that in the control group[(86.12±15.08)pg/mL],the levels of sFlt-1 and activin A were(986.59±168.73)and(398.08±86.45)pg/mL,respectively,which were higher than those in the control group[(712.42±102.36)and(201.23±45.71)pg/mL],and the differences were statistically significant(P<0.05).The level of serum PLGF in pregnant women with severe preeclampsia was lower than that of pregnant women with mild preeclampsia,and the levels of sFlt-1 and activin A were higher than those of pregnant women with mild preeclampsia,and the differences were statistically significant(P<0.05).According to Pearson correlation analysis,there was a negative correlation between serum PLGF and urine protein in pregnant women with preeclampsia(P<0.05),and a positive correlation with platelet count(P<0.05);the levels of serum sFlt-1 and activin A in pregnant women with preeclampsia were positively correlated with urinary protein(P<0.05),and negatively correlated with platelet count(P<0.05).The sensitivity,specificity and AUC of serum PLGF and sFlt-1 combined with activin A in the diagnosis of preeclampsia were 90.47%,51.64%and 0.926.By single factor and multiple factors Logistic regression analysis,production time,delivery gestational age,albumin,PLGF,sFlt-1 and activin A were independent influencing factors for adverse maternal and infant outcomes in preeclampsia pregnant women(P<0.05).Conclusion Serum PLGF,sFlt-1 and activin A associate with preeclampsia occurrence and its serious degree,joint application can improve the diagnostic performance of preeclampsia,and all are the independent factors affecting maternal aderse outcome.