PLGF、sFlt-1、D_(2)、PLR检测对子痫前期发生的预测价值

Prognostic value of PLGF,sFlt-1,D_(2) and PLR in the occurrence of preeclampsia

目的:探讨胎盘生长因子(Placen-tal growth factor,PLGF)可溶性fams样酪氨酸激酶(sFLT-1)、D-二聚体(D-dimer,D-D)及血小板/淋巴细胞(PLR)对子痫前期(Pre-Eclampsia,PE)的预测价值。方法:选取2021年1月-2023年6月在本院产检中确诊为子痫前期的孕妇90例,并根据患者病情严重程度分为轻度PE70例,重度PE20例;同时选取在此期间内正常分娩的90例孕妇为对照组。收集并分析两组孕妇血清PLGF、sFlt-1、D-D及外周血血小板(platelet,plt)数、淋巴细胞数。采用受试者工作特征曲线(receiver operator characteristic curve,ROC)评估PIGF、sFlt-1、sFlt-1/PLGF、D-D、PLR对孕妇发生子痫前期的预测价值。各参数之间的相关性同时采用Spearman方法分析。结果:PE组sFlt-1、sFlt-1/PLGF、D-D水平明显高于对照组,PLGF、Plt、PLR水平明显低于对照组,差异具有统计学意义(P<0.01);重度PE组sFlt-1、sFlt-1/PLGF水平高于轻度PE组,PLGF水平明显低于轻度PE组,差异具有统计学意义(P<0.01)。PLGF、sFlt-1、sFlt-1/PLGF、D-D、PLR预测子痫前期的曲线下面积(Area Under Curve,AUC)分别为0.886、0.911、0.924、0.874、0.808,相关性分析显示,D-D与PLGF、PLR水平呈负相关(r=-0.234,P=0.026;r=-0.491,P<0.0001),与sFlt-1、sFlt-1/PLGF水平呈正相关(r=0.337,P<0.01;r=0.292,P<0.01)。结论:sFlt-1、PLGF、sFlt-1/PLGF对PE均有良好的诊断价值,联合检测有利于临床对PE的诊断。

Objective:Exploring the predictive value of placental growth factor(PLGF),soluble fams like tyrosine kinase(sFLT-1),D-dimer(D-D),and platelet/lymphocyte(PLR)for preeclampsia(PE).Methods:A total of 90 pregnant women diagnosed with preeclampsia during prenatal examinations in our hospital from January 2021 to June 2023 were selected.According to the severity of the patient's condition,they were divided into 70 cases of mild PE and 20 cases of severe PE.Meanwhile,90 pregnant women who gave birth normally during this period were selected as the control group.Collect and analyze serum PLGF,sFlt-1,D-D,and peripheral blood platelet(PLT)count and lymphocyte count from two groups of pregnant women.Serum PLGF,sFlt-1,D-D,platelet count and lymphocyte count in peripheral blood were collected and analyzed.Evaluate the predictive value of PIGF,sFlt-1,sFlt-1/PLGF,D-D,and PLR on the occurrence of preeclampsia in pregnant women using Receiver Operating Characteristic(ROC)curves.The correlation between various parameters was analyzed using Spearman method simultaneously.Results:The levels ofsFlt-1,sFlt-1/PLGF,and D-D in the PE group were significantly higher than those in the control group,while the levels of PLGE,Plt,and PLR were significantly lower than those in the control group(P<0.01).The levels ofsFlt-1 and sFlt-1/PLGFin the severe PE group were higher than those in the mild PE group,and the levels of PLGF were significantly lower than those in the mild PE group(P<0.01).The area under the curve(AUC)of PLGF,sFlt-1,sFlt-1/PLGF,D-D,and PLR predicting preeclampsia were 0.886,0.911,0.924,0.874,and 0.808,respectively.Correlation analysis showed that D-D was negatively correlated with PLGF and PLR levels(r-=-0.234,P=0.026;r=-0.491,P<0.001),and positively correlated with sFlt-1 and sFlt-1/PLGF levels(r=0.337,P<0.01;r-0.292,P<0.01).Conclusion:sFlt-1,PLGF and sFlt-1/PLGF all have good diagnostic value in preeclampsia.Combined detection is beneficial to the clinical diagnosis of PE.