血管生成标志物、心血管功能指标联合检测对先兆子痫及胎儿心肌畸形的预测价值

Study on the Predictive Value of Combined Detection of Angiogenesis Markers and Cardiovascular Function Indexes in Preeclampsia

探讨血管生成标志物和心功能指标联合检测对先兆子痫(PE)的预测价值。选择129例先兆子痫患者(PE组)及110例健康孕产妇(对照组)为研究对象,采用彩色多普勒超声检查记录孕产妇心血管功能,采集外周血,利用自动电化学发光免疫分析法检测sFlt-1、PlGF和NT-proBNP表达水平。结果:(1)与对照组相比,PE组患者的平均UTA-PI、脐动脉PI显著较高,大脑中动脉PI明显较低,同时,PE组的MAP、TPRI、sFlt-1/PlGF比值和NT-proBNP水平显著更高(P<0.05),sFlt-1/PlGF、NT-proBNP和TPRI对PE发生的影响最为显著。(2)ROC曲线(受试者工作曲线)显示,sFlt-1/PlGF、TPRI、NT-proBNP诊断PE的曲线下面积(AUC)分别为0.636、0.658、0.797。(3)胎儿右心室SRS和SRD、左心室SRS和SRD与母体收缩压呈显著正相关关系(r=0.562、0.593、0.661、0.716),同时,胎儿右心室SRS和SRD、左心室SRS和SRD与母体NT-proBNP呈中等正相关关系(r=0.428、0.493、0.427、0.396)。血管生成标志物和心功能指标联合检测对PE有较高的预测价值,且母体外周血NT-proBNP水平与胎儿心肌畸形有明显相关性。

To explore the predictive value of combined detection of angiogenesis markers and cardiac function indexes in preeclampsia(PE),129 pregnant women with PE(PE group)and 110 healthy pregnant women(control group)were selected as the subjects,and the expression of sFlt-1/PIGF、NT-proBNP were recorded.Results showed:(1)Compared with the control group,the average UTA-PI,and umbilical artery PI in PE group were significantly higher,while the middle cerebral artery PI in PE group was significantly lower,the MAP,TPRI,sFlt-1/PlGF ratio and NT proBNP level in PE group were significantly higher(P<0.05).SFlt-1/PlGF,NT proBNP and TPRI had the most significant effects on PE.(2)ROC curve(subject working curve)showed that the area under the curve(AUC)of sFlt-1/PlGF,TPRI and NT proBNP were 0.636,0.658 and 0.797 respectively.(3)There was a significant positive correlation between fetal right ventricular SRS and SRD,left ventricular SRS and SRD and maternal systolic blood pressure(r=0.562、0.593、0.661、0.716).At the same time,fetal right ventricular SRS and SRD,left ventricular SRS and SRD and maternal NT proBNP were moderately positively correlated.The combined detection of angiogenesis markers and cardiac function indexes has high predictive value for PE,and the level of NT proBNP in maternal peripheral blood is significantly correlated with fetal myocardial malformation(r=0.428、0.493、0.427、0.396).The combined detection of angiogenesis markers and cardiac function indexes has high predictive value for PE.