可溶性fms样酪氨酸激酶1与胎盘生长因子比值及维生素D水平和晚发型子痫前期患者疾病严重程度及妊娠结局的相关性研究

Study on the correlation between the ratio of soluble fms-like tyrosine kinase-1 to placental growth factor and vitamin D level with disease severity and pregnancy outcome in patients with late-onset preeclampsia

目的探讨可溶性fms样酪氨酸激酶1与胎盘生长因子比值(sFlt-1/PLGF)及维生素D水平和晚发型子痫前期孕妇疾病严重程度及妊娠结局的相关性。方法收集2021年7月至2023年12月于首都医科大学附属北京安贞医院妇产科进行产前检查和分娩的121例晚发型子痫前期患者的临床资料进行回顾性研究。根据病情严重程度分为重度组(61例)和非重度组(60例)。于孕34周后测定血清sFlt-1/PLGF及25-羟基维生素D[25-(OH)-D]水平,跟踪随访记录研究对象包括24 h尿蛋白水平、分娩孕周、新生儿体重等在内的妊娠结局。结果重度组患者血清sFlt-1/PLGF高于非重度组[38.20(21.66,69.22)比25.59(16.74,51.54)],差异有统计学意义(P<0.05)。重度组患者血清25-(OH)-D水平低于非重度组,但差异无统计学意义(P>0.05)。重度组患者血清sFlt-1/PLGF与新生儿体重呈负相关(r=-0.267,P=0.038),与24 h尿蛋白水平呈正相关性(r=0.377,P=0.003),而与分娩孕周无明显相关性(P=0.645)。结论与非重度子痫前期患者相比,重度子痫前期患者血清sFlt-1/PLGF明显升高,而2组血清维生素D水平相似。此外,重度子痫前期患者sFlt-1/PLGF与24 h尿蛋白水平呈正相关、与新生儿体重呈负相关,提示血清sFlt-1/PLGF对不良妊娠结局可提供预测作用,本研究或为临床上早期诊断、早期治疗子痫前期提供新思路、新方法。

Objective To investigate the correlation between the ratio of soluble fms-like tyrosine kinase-1 to placental growth factor(sFlt-1/PLGF)and vitamin D level with disease severity and pregnancy outcome in pregnant women with late-onset preeclampsia.Methods The clinical data of 121 patients with late-onset preeclampsia who underwent prenatal examination and delivery in Department of Obstetrics and Gynecology,Beijing Anzhen Hospital,Capital Medical University from July 2021 to December 2023 were collected for a retrospective study.According to the severity of the disease,they were divided into severe group(61 cases)and non-severe group(60 cases).After 34 weeks of pregnancy,serum sFlt-1/PLGF and 25-(OH)-D level were measured,and the pregnancy outcomes of the study subjects,including 24 h urine protein levels,gestational weeks of delivery,and newborn weight,were tracked and recorded.Results The serum sFlt-1/PLGF in the severe group was higher than that in the non-severe group[38.20(21.66,69.22)vs 25.59(16.74,51.54)](P<0.05).The serum 25-(OH)-D level in the severe group was lower than that in the non-severe group(P>0.05).The serum sFlt-1/PLGF in severe group was negatively correlated with neonatal weight(r=-0.267,P=0.038)and positively correlated with 24 h urine protein level(r=0.377,P=0.003),but not significantly correlated with gestational age at delivery(P=0.645).Conclusion Compared with patients with non-severe preeclampsia,serum sFlt-1/PLGF in patients with severe preeclampsia is significantly higher,but there is no significant difference in serum vitamin D level between the two groups.In addition,serum sFlt-1/PLGF in patients with severe preeclampsia is positively correlated with 24 h urinary protein level and negatively correlated with neonatal weight,suggesting that serum sFlt-1/PLGF may play a role in the prediction of adverse pregnancy outcomes.This study may provide new ideas and methods for early diagnosis and early treatment of preeclampsia.