Plasma Nogo-A and placental growth factor levels are associated with portal hypertension in patients with liver cirrhosis

BACKGROUND Clinically significant portal hypertension(CSPH) and severe portal hypertension(SPH) increase the risk for decompensation and life-threatening complications in liver cirrhosis. Pathologic angiogenesis might contribute to the formation of these conditions. Placental growth factor(PlGF) and Nogo-A protein are biomarkers of pathological angiogenesis, but data on their role in liver cirrhosis and portal hypertension is scarce.AIM To determine plasma levels of PlGF and Nogo-A in patients with liver cirrhosis,CSPH, SPH and potential to predict portal hypertension.METHODS A cohort of 122 patients with hepatitis C virus and/or alcohol-induced liver cirrhosis with characterized hepatic venous pressure gradient(HVPG) were included in the study. Demographic data, medical history, Child-Turcotte-Pugh and Model of End Stage liver disease score, clinical chemistry, liver stiffnessvalues were recorded on the day of the procedure prior HVPG measurement. The degree of portal hypertension was determined by the invasive HVPG measurement. Nogo-A and PlGF plasma levels were evaluated using enzyme linked immunosorbent assay. The control group consisted of 30 healthy age-and sex-matched individuals.RESULTS Peripheral PlGF levels were higher and Nogo-A levels were lower in patients with liver cirrhosis(23.20 vs 9.85;P < 0.0001 and 2.19 vs 3.12;P = 0.004 respectively). There was a positive linear correlation between peripheral levels of PlGF and HVPG(r = 0.338, P = 0.001) and negative linear correlation between the peripheral Nogo-A levels and HVPG(r =-0.267, P = 0.007). PlGF levels were higher in CSPH and SPH(P = 0.006;P < 0.0001) whereas Nogo-A levels were lower(P = 0.01;P < 0.033). Area under the curve for the diagnosis of CSPH for PlGF was 0.68(P = 0.003) and for Nogo-A-0.67(P = 0.01);for SPH 0.714(P <0.0001) and 0.65(P = 0.014) respectively. PlGF levels were higher and Nogo-A levels were lower in patients with esophageal varices(P < 0.05). PlGF cut-off value of 25 pg/mL distinguished patients with CSPH at 55.7% sensitivity and76.7% specificity;whereas Nogo-A cut-off value of 1.12 ng/mL was highly specific(93.1%) for the diagnosis of CSPH.CONCLUSION Plasma PlGF levels were higher while Nogo-A levels were lower in patients with liver cirrhosis and portal hypertension. Biomarkers showed moderate predictive value in determining CSPH and SPH.

Inhibitory effect on subretinal fibrosis by anti-placental growth factor treatment in a laser-induced choroidal neovascularization model in mice

AIM:To investigate whether anti-placental growth factor(PGF) can inhibit subretinal fibrosis and whether this effect is mediated by the inhibitory effect of PGF on epithelial-mesenchymal transition(EMT) of retinal pigment epithelial(RPE) cells.METHODS:Subretinal fibrosis model was established in laser induced choroidal neovascularization(CNV) mice on day 21 after laser photocoagulation.Immunofluorescence staining(IFS) of cryosections and enzyme-linked immunosorbent assay(ELISA) were used to detect the expression of PGF.IFS of whole choroidal flat-mounts was used to detect the degree of subretinal fibrosis.IFS of cryosections and ELISA were used to detect the expression of EMT related indicators in subretinal fibrosis lesions.RESULTS:The expression of PGF protein in subretinal fibrosis lesions was significantly up-regulated(P<0.05),and mainly co-stained with pan-cytokeratin labeled RPE cells.Intravitreal injection of anti-PGF neutralizing antibody reduced the area of subretinal fibrosis and the ratio of fibrotic/angiogenic area significantly at the concentrations of 0.25,0.5,1.0,and 2.0 μg/μL(all P<0.05).The expression of E-cadherin in the local RPE cells decreased,while α-SMA increased significantly in subretinal fibrosis lesions,and the application of anti-PGF neutralizing antibody could reverse these changes(P<0.05).CONCLUSION:The expression of PGF is up-regulated in the lesion site of subretinal fibrosis and mainly expressed in RPE cells.Intravitreal injection of anti-PGF neutralizing antibody can significantly inhibit the degree of subretinal fibrosis in CNV mice,and this effect may be mediated by the inhibition of PGF on EMT of RPE cells.

Analysis of Placental Growth Factor in Placentas of Normal Pregnant Women and Women with Hypertensive Disorders of Pregnancy

To investigate the expressions of placental growth factor （PLGF） in placenta with hypertensive disorders of pregnancy （ HDP）, 45 women with HDP and 20 normally pregnant women were studied. Among 45 women with HDP, there were 23 cases of severe preeclampsia and one case of eclampsia. The location and level of PLGF proteins was determined by immunohistochemistry and Western blot. The expression of PLGF mRNA in placenta was assessed by reverse transcriptionalpolymerase chain reaction （RT-PCR）. The results showed that： （1） The distribution of PLGF in placenta with HDP was similar to normal one, which was mainly in the cytoplasm of villous syncytiotrophoblast and villous stroma; （2） The expression of PLGF protein was significantly decreased in placentas with mild and severe preeclampsia compared to the normal ones （0.3±0.4 vs 0.6± 0.4, 0.2±0.5 vs 0. 6±0. 4, P〈0.01）. There were no differences between the gestational hypertension placenta and normal one （0.5±0.6 vs 0. 6±0. 4, P〉0.05） ; （3） The transcription levels of the PLGF mRNA in placentas with preeclampsia were significantly lower than in normal groups （3.33±0.39 vs 4.87±0. 60, 1.97±0.29 vs 4.87±0.60, P〈0.01）, and no differences were found between the gestational hypertension placenta and normal groups. These findings suggest that the abnormal expression of PLGF in placentas is related to the pathogenesis of HDP.

Effect of Compound Danshen Injection Combined with Labetalol on Liver Function and Placental Growth Factor in Patients with Eclampsia

Objective: To explore the effect of Compound Danshen Injection combined with Labetalol on liver function and placental growth factor in patients with eclampsia. Methods: Seventy patients with eclampsia who were treated in the Hospital from February 2017 to February 2019 were enrolled. The patients were divided into two groups according to the random number table, with 35 cases in each group. The Observation group was treated with Labetalol, and the combined therapy group was treated with Compound Danshen Injection combined with Labetalol. The liver function [alanine aminotransferase, aspartate aminotransferase, total protein, and albumin], hemorheology indicators, placental growth factor and serum insulin-like growth factor-1 and clinical indicators in the two groups were analyzed. Results: After treatment, the levels of alanine aminotransferase and aspartate aminotransferase in the combined therapy group were significantly lower than those in the Observation group. The levels of total protein and albumin in the combined therapy group were significantly higher than those in the Observation group (P<0.05). After treatment, the high-cut and low-cut whole blood viscosity, plasma viscosity and erythrocyte rigidity index in the combined therapy group were significantly lower than the Observation group, and the difference was statistically significant (P<0.05). After treatment, the levels of PLGF and IGF-1 in the combined therapy group were significantly higher than those in the Observation group, and the difference was statistically significant (P<0.05). After treatment, the gestational age, neonatal weight index, placental weight and neonatal 1 min Apgar score in the combined therapy group were significantly higher than the Observation group, and the difference was statistically significant (P<0.05). Conclusion: For patients with eclampsia, Compound Danshen Injection combined with Labetalol is with great safety, which can help stabilize their condition, and improve their liver function and placental growth factor status.

Associations between Placental Insulin-Like Growth Factor-1 Gene Expression, DNA Methylation and Intrauterine Growth Restriction

Intrauterine growth restriction (IUGR) is a common fetal development disorder which has great impact on neonatal health. Insulin-like growth factor-1 (IGF1) has an important role in regulating fetal growth. Whether IGF1 DNA methylation was associated with IUGR has not been studied. Placenta samples from IUGR (n = 27) and normal delivery (n = 29) were collected whereas basic information of mothers and infants were also collected. RT-PCR was performed to examine IGF1 transcriptions and bisulfite sequencing PCR was used for DNA methylation analysis. Gene expression analysis found IUGR had significantly lower IGF1 transcription compared to control group (IUGR: 0.330 ± 0.351;control group: 1.001 ± 0.800, t = 3.995, P IGF1 were all highly methylated and there is no difference on DNA methylation rate between IUGR and control group (IUGR: 75%;control group: 81%;P = 0.09). Interestingly, in both IUGR and control groups, male fetus had significantly higher methylation rate than female fetus (IUGR: male: 87%;female: 74%, P = 0.016;control: male: 82%;female: 69%, P = 0.012). There was no correlation between IGF1gene expression and DNA methylation rate (r = 0.095, P = 0.063). Intrauterine fetal growth restriction placenta had significantly lower IGF1gene expression;however, IGF1 DNA methylation level was similar. A potential fetus gender difference was also found in IGF1 DNA methylation rate.

血清PLGF/sFlt-1联合胎盘3D-PDI对子痫前期的预测价值

目的探讨血清胎盘生长因子(PLGF)/可溶性血管内皮生长因子受体-1(sFlt-1)联合胎盘三维能量多普勒指数(3D-PDI)对子痫前期(PE)的预测价值。方法选取2021年1月至2022年12月于我院就诊且有PE高危因素的孕妇120例,随访至分娩后1周。于孕14~20周常规产检时检测血清PLGF和sFlt-1水平,并计算PLGF/sFlt-1比值,同时超声检测胎盘3D-PDI,包括血管化指数(VI)、血流指数(FI)、血管化-血流指数(VFI)。根据孕20周后是否发生PE,分为PE组(55例)和对照组(65例),根据病情轻重将PE组进一步分为非重度PE组(35例)和重度PE组(20例)。比较各组PLGF/sFlt-1及3D-PDI,并分析PLGF、sFlt-1与3D-PDI的相关性,绘制受试者操作特征(ROC)曲线,分析各指标单独或联合预测PE的价值。结果2组孕妇年龄、检测孕周、妊娠高血压史及生育史等均无差异(P>0.05)。PE组收缩压(SBP)、舒张压(DBP)、24 h尿蛋白水平、早产率、新生儿重症监护室入住率及孕前体质量指数均高于对照组(P<0.05),新生儿体质量低于对照组(P<0.05)。PE组血清PLGF/sFlt-1、3D-PDI均低于对照组,重度PE组血清PLGF/sFlt-1、3D-PDI均低于非重度PE组(均P<0.05)。PLGF与VFI呈显著正相关(P<0.01),sFlt-1与VFI呈显著负相关(P<0.01)。ROC曲线分析显示,PLGF/sFlt-1、VI、FI、VFI对PE均有预测价值,VI、FI、VFI联合预测PE的价值高于各参数指标[曲线下面积(AUC)=0.951],血清PLGF/sFlt-1、VI、FI、VFI四者联合预测价值最高(AUC=0.987)。结论PE患者孕早期血清PLGF、sFlt-1与胎盘VFI均具有显著相关性,且孕早期血清PLGF/sFlt-1及胎盘VI、FI、VFI均减低,4种指标联合应用预测PE的效能最高,可为临床早期筛查或预测PE提供参考。

母血DCN、sEng、PLGF水平与早发型胎儿生长受限的相关性分析

目的:分析母血核心蛋白聚糖(DCN)、可溶性内皮因子(sEng)、胎盘生长因子(PLGF)与早发型胎儿生长受限(FGR)的相关性。方法:选取2021年1—12月于湖南省妇幼保健院分娩的120例FGR孕妇作为研究对象,其中早发型FGR 42例纳入早发型FGR组,晚发型FGR 78例纳入晚发型FGR组。选取同期分娩正常胎儿的120例孕妇作为对照组。比较三组母血血清DCN、sEng、PLGF水平及三组新生儿生长发育指标,分析母血血清DCN、sEng、PLGF水平与早发型新生儿生长发育指标的相关性。结果:早发型FGR组DCN、sEng水平高于晚发型FGR组、对照组,PLGF水平低于晚发型FGR组、对照组,差异有统计学意义(P<0.05);晚发型FGR组、对照组DCN、sEng、PLGF水平比较,差异无统计学意义(P>0.05)。三组新生儿体质量、腹围、头围、股骨长比较,早发型FGR组<晚发型FGR组<对照组,差异有统计学意义(P<0.05)。DCN、sEng水平与早发型FGR新生儿体质量、腹围、头围、股骨长呈负相关(P<0.05);PLGF与早发型FGR新生儿体质量、腹围、头围、股骨长呈正相关(P<0.05)。结论:母血DCN、sEng、PLGF水平与早发型FGR存在相关性,可用于早发型FGR的筛查、诊断。

Effect of Bushen Yiqi Huoxue Recipe on Placental Vasculature in Pregnant Rats with Fetal Growth Restriction Induced by Passive Smoking

Interactions of vascular endothelial growth factor （VEGF） with receptors VEGFR1/Fltl and VEGFR2/Flk1, and those of angiopoietins （Ang-1, Ang-2） with receptor Tie2 play important roles in placental angiogenesis. This study investigated vascular morphology and expression of these angiogenic factors in rat placenta on the day 15, 18, 21 of gestation （D 15, D 18 and D21）. The rats were randomly assigned into 3 groups： normal group, model group [fetal growth restriction （FGR） model], and Bushen Tqi Huoxue （BYHR） recipe treatment group （BYHR group, the pregnant rats with FGR were treated with BYHR recipe）. Morphological analysis indicated that during initial villous formation, fetal nucle- ated erythrocytes （FNEs） appeared in maternal blood sinus （MBS）. Subsequently, FNEs were sur- rounded by endothelial cells to form fetal capillary （FC） and then by trophoblast cells to form villi. As pregnancy proceeded, FC density increased progressively with increasing endothelial identification staining （EIS） in normal and BYHR groups. Whereas, villous formation was suppressed, normal in- crease in FC density was impaired and EIS was weakened in model group. Quantitative PCR analysis showed that VEGF and Flkl mRNA increased over gestation in all groups, indicating that VEGF might play a pivotal role in FC growth during late gestation. VEGF mRNA was increased on D15, while de- creased on D21 in model group as compared with normal group and BYHR group. Immunohistochemi- cally, Ang-2 protein was highly expressed in FNEs, gradually disappeared as villi matured, and decreased over gestation in all groups, indicating that Ang-2 might play a pivotal role in villous formation, which was further supported by decreased Ang-2 mRNA and protein expression in model group on D 15. Ang-1 mRNA, Tie2 mRNA and Ang-1/Ang-2 ratio increased from D15 to D18 in all groups as placenta matured. Ang-1 mRNA, Tie2 mRNA and Ang-1/Ang-2 ratio were decreased on D18 in model group as compared with normal and BYHR groups, indicating delayed maturity of FGR placenta. Alterations in angiogenic factors may result in altered placental vasculature and cause placental insufficiency. BYHR recipe could balance the angiogenic factors to promote the formation and maturation of FGR placental vasculature.

血清PAPP-A、PP13和sFlt-1/PlGF比值检测对子痫前期高危孕妇患病的预测价值

目的分析血清妊娠相关α血浆蛋白(PAPP-A)、胎盘蛋白13(PP13)和可溶性胎盘血管内皮生长因子受体-1(sFlt-1)/胎盘生长因子(PlGF)比值检测对子痫前期(PE)高危因素孕妇PE发生的预测价值。方法选取2021年3月至2023年3月合肥市第二人民医院收治的187例具有PE高危因素的孕妇,根据妊娠20周后是否发生PE分为患病组(28例)和未患病组(159例)。收集所有孕妇一般资料,并采用酶联免疫吸附试验检测所有孕妇血清PAPP-A、PP13、sFlt-1、PlGF水平,采用Pearson相关分析各指标的关系,绘制受试者工作特征(ROC)曲线评估各项指标对PE发生的预测价值。结果妊娠16周及分娩前患病组血清PAPP-A水平均低于未患病组,血清PP13水平均高于未患病组,sFlt-1/PlGF比值均高于未患病组,差异有统计学意义(t值介于4.198~8.173之间,P<0.05);患病组孕妇经干预治疗后血清PAPP-A水平升高,血清PP13水平降低,sFlt-1/PlGF比值降低,差异有统计学意义(t值介于2.024~3.671之间,P<0.05);血清PAPP-A水平与PP13、sFlt-1/PlGF比值均呈负相关性(r值分别为-0.836、-0.775,P<0.05),血清PP13水平与sFlt-1/PlGF比值呈正相关性(r=0.670,P<0.05);ROC分析结果显示,血清PAPP-A、PP13、sFlt-1/PlGF预测PE发生的曲线下面积(AUC)分别为0.810、0.805、0.798,均有一定的预测价值(P<0.05)。结论血清PAPP-A、PP13和sFlt-1/PlGF比值对PE高危因素孕妇发生PE有较高的预测价值。

sFlt-1/PlGF比值联合D-二聚体评估子痫前期妊娠结局的临床价值

目的探讨可溶性fms样酪氨酸激酶1(sFlt-1)/胎盘生长因子(PlGF)比值联合D-二聚体(D-D)评估子痫前期(PE)妊娠结局的临床价值。方法回顾性选取2021年12月至2023年1月收治的102例PE患者作为子痫前期组,另选取同期在我院进行产前检查的正常孕妇60例作为对照组,比较两组28至32周时血清sFlt-1、PlGF、sFlt-1/PlGF比值、D-D水平,采用受试者工作特征(ROC)曲线分析sFlt-1/PlGF比值联合D-D对妊娠结局的预测价值。结果子痫组血清sFlt-1、sFlt-1/PlGF比值、D-D水平高于对照组,PlGF水平低于对照组(t值分别为10.855、20.310、17.002和15.365,P<0.05);Logistic分析显示,高体质量指数(BMI)、妊娠期糖尿病或肾病、既往子痫前期史、sFlt-1/PlGF比值、D-D均为影响孕妇发生子痫前期的独立危险因素,其OR值及95%CI分别为18.171(6.493~50.849)、4.259(1.096~16.547)、11.367(1.226~105.391)、7.939(2.514~25.068)和1.567(1.330~1.845),P<0.05。不良妊娠结局组血清sFlt-1、sFlt-1/PlGF比值、D-D水平高于非不良妊娠结局组,PlGF水平低于非不良妊娠结局组(t值分别为4.759、5.646、5.331和3.135,P<0.05)。ROC曲线显示,sFlt-1/PlGF比值联合D-D预测妊娠结局的曲线下面积(AUC)为0.843,灵敏度和特异度分别为79.41%和75.00%。结论子痫前期患者血清sFlt-1/PlGF比值、D-D水平升高,二者可用于评估子痫前期妊娠结局。

sFlt-1及PlGF在子痫前期患者胎盘中的表达及相关性研究

目的探讨可溶性FMS样酪氨酸激酶-1(sFlt-1)及胎盘生长因子(PlGF)在子痫前期患者胎盘中的表达及相关性。方法选择2021年8月—2022年12月住院分娩的诊断为子痫前期孕妇(研究组,10例)及正常孕妇(对照组,12例)作为研究对象,收集其临床资料及分娩时的胎盘组织,应用蛋白质印迹法(WB)检测胎盘组织中sFlt-1及PlGF的表达。结果与对照组相比,研究组孕妇的年龄和体重指数无统计学差异(均P>0.05);对照组尿蛋白均为阴性,研究组尿蛋白均为阳性;研究组孕周和新生儿体重显著低于对照组(均P<0.01);收缩压和舒张压显著高于对照组(均P<0.01)。WB检测发现,与对照组比较,研究组胎盘组织中的sFlt-1表达水平显著高于对照组,差异有统计学意义(Z=-3.962,P<0.01);PlGF在研究组中的表达显著低于对照组,差异有统计学意义(Z=-3.957,P<0.01)。结论胎盘组织中抗血管因子sFlt-1表达的升高、促血管形成因子PlGF的下降异常可调节血管舒缩,参与子痫前期的发生、发展及靶器官受损。

血清VEGF、PLGF在新诊断非霍奇金淋巴瘤并发血栓栓塞症患者中的水平及临床意义

目的探讨血清血管内皮生长因子(VEGF)、胎盘生长因子(PLGF)在非霍奇金淋巴瘤并发血栓栓塞症患者中的水平及意义。方法选取2020年8月至2023年8月郑州大学第一附属医院收治的101例采用一线化疗方案治疗的新诊断非霍奇金淋巴瘤患者作为研究对象。根据治疗期间是否并发血栓栓塞症将所有患者分为发生组与未发生组。比较两组患者基线资料及血清VEGF、PLGF水平等,使用多因素Logistic回归分析血清VEGF、PLGF对非霍奇金淋巴瘤并发血栓栓塞症的影响。绘制受试者工作特征(ROC)曲线分析血清VEGF、PLGF及二者联合对非霍奇金淋巴瘤并发血栓栓塞症的诊断价值。结果化疗期间,101例非霍奇金淋巴瘤患者中并发血栓栓塞症22例,发生率为21.78%。两组患者白细胞计数、性别、年龄等基线资料比较,差异均无统计学意义(P>0.05);发生组血清VEGF、PLGF水平明显高于未发生组,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,血清VEGF、PLGF水平升高是非霍奇金淋巴瘤并发血栓栓塞症的危险因素(P<0.05)。ROC曲线分析结果显示,血清VEGF、PLGF诊断非霍奇金淋巴瘤并发血栓栓塞症的曲线下面积(AUC)分别为0.841、0.839,二者联合诊断的AUC为0.908,联合诊断的AUC明显大于二者单独检测的AUC(P<0.05)。结论非霍奇金淋巴瘤并发血栓栓塞症患者血清VEGF、PLGF水平呈升高状态,血清VEGF、PLGF在诊断非霍奇金淋巴瘤并发血栓栓塞症方面具有较高的应用价值,且以二者联合诊断价值最高。

血清Gal-3、PLGF与重度子痫前期患者胎盘早剥的关系

目的 观察重度子痫前期患者血清半乳糖凝集素3(Gal-3)、胎盘生长因子(PLGF)表达情况及其与胎盘早剥的关系。方法 选取2019年1月至2021年1月南阳市第一人民医院接受诊疗的98例重度子痫前期患者为研究对象,统计患者胎盘早剥情况并将其分为胎盘早剥组与无胎盘早剥组,所有患者入院时均接受血清Gal-3、PLGF检测,分析重度子痫前期患者血清Gal-3、PLGF与胎盘早剥的关系。结果 98例重度子痫前期患者中发生胎盘早剥17例,占17.35%;胎盘早剥组血清Gal-3水平高于无胎盘早剥组,血清PLGF、血红蛋白水平低于无胎盘早剥组,差异有统计学意义(P<0.05);经logistic回归分析,结果显示,Gal-3、PLGF、血红蛋白异常表达与中度子痫前期患者胎盘早剥有关(P<0.05);绘制受试者工作特征曲线,结果显示,血清Gal-3、PLGF预测重度子痫前期患者胎盘早剥发生的AUC均>0.8,具有一定预测价值,且联合检测的价值最高。结论 重度子痫前期胎盘早剥患者Gal-3呈高表达,PLGF呈低表达,且血清Gal-3、PLGF水平与重度子痫前期患者胎盘早剥密切相关。

HDP患者血清PLGF、IFI16、ANGPTL2与不良妊娠结局关系及预测价值

目的:研究妊娠高血压疾病(HDP)患者血清胎盘生长因子(PLGF)、γ干扰素诱导蛋白16(IFI16)、血管生成素样蛋白2(ANGPTL2)水平及预测妊娠结局价值。方法:选取2020年1月-2023年1月在本院就诊并分娩的126例HDP孕妇,根据病情严重程度分为轻度组(58例)、重度组(68例),依据妊娠结局分为不良组(52例)、良好组(74例)。同期在本院健康分娩的孕妇60例为健康组。检测血清甘油三酯(TG)、总胆固醇(TC)、糖化血红蛋白(HbA1c)、PLGF、IFI16、Angptl2蛋白表达和尿液中24 h尿蛋白、尿酸(UA)、肌酐(Cr)水平,血清。Spearman分析PLGF、IFI16、Angptl2与HDP严重程度和妊娠结局的相关性;logistic分析不良妊娠结局影响因素;受试者工作特征(ROC)曲线分析PLGF、IFI16、ANGPTL2对HDP孕妇不良妊娠结局的预测价值。结果:健康组、轻度组、重度组血清PLGF水平依次降低,IFI16、ANGPTL2依次升高;良好组舒张压、收缩压、24 h尿蛋白、IFI16、ANGPTL2低于不良组,PLGF高于不良组(均P<0.05)。HDP严重程度、不良妊娠结局与PLGF呈负相关,与IFI16、ANGPTL2呈正相关(P<0.05)。舒张压、收缩压、IFI16、ANGPTL2异常升高是影响HDP患者不良妊娠结局的危险因素,PLGF升高是保护因素(P<0.05)。PLGF、IFI16、ANGPTL2联合检测预测HDP患者不良妊娠结局的曲线下面积为0.905,灵敏度98.1%、特异度73.0%,价值高于单独指标检测(P<0.05)。结论:HDP患者血清PLGF较低,IFI16、ANGPTL2较高,PLGF、IFI16、ANGPTL2联合检测可提高不良妊娠结局预测价值。

血清sFlt-1、PLGF与子痫前期发病及病情严重程度的关系

目的 探讨血清可溶性类fms酪氨酸激酶-1(sFlt-1)、胎盘生长因子(PLGF)与子痫前期发病及病情严重程度的关系。方法 前瞻性纳入2021年1月至2023年5月长治医学院附属和平医院收治的子痫前期孕妇100例为观察组,另选取同期100名健康孕妇为对照组。检测并比较两组血清sFlt-1、PLGF水平,通过受试者工作特征(ROC)曲线分析血清sFlt-1、PLGF水平对子痫前期发病的预测价值,同时比较不同病情严重程度子痫前期孕妇基线资料(年龄、孕周、体重指数、孕次)及血清sFlt-1、PLGF水平,最后通过Spearman秩相关分析不同病情严重程度的子痫前期孕妇与血清PLGF、sFlt-1水平的相关性。结果 观察组血清sFlt-1为(31.26±8.38)μg/L,高于对照组[(16.48±3.45)μg/L],血清PLGF水平为(1.17±0.25)μg/L,低于对照组[(1.72±0.28)μg/L],差异均有统计学意义(P<0.05)。经ROC曲线分析证实血清sFlt-1、PLGF水平可预测子痫前期,曲线下面积为0.941、0.949,均有较好预测价值(P<0.05)。轻度与高度子痫前期孕妇年龄、孕周、体重指数、孕次比较,差异均无统计学意义(P>0.05);重度子痫前期孕妇血清sFlt-1水平为(36.97±10.87)μg/L,高于轻度子痫前期孕妇[(26.45±6.78)μg/L],血清PLGF水平为(1.05±0.31)μg/L,高于轻度子痫前期孕妇[(1.31±0.22)μg/L],差异均有统计学意义(P<0.05)。血清sFlt-1与病情严重程度呈正相关(r=4.564,P<0.05),PLGF水平与病情严重程度呈负相关(r=-5.164,P<0.05)。结论 血清sFlt-1水平与子痫前期孕妇病情严重程度呈正相关,血清PLGF水平与子痫前期患者病情严重程度呈负相关,临床医师应对上述指标密切监测,以预测疾病发生与进展。

血清FGF-23、PLGF、TyG指数联合检测对妊娠期糖尿病患者不良妊娠结局的预测效能

目的:探讨血清成纤维细胞生长因子-23(Fibroblast growth factor-23,FGF-23)、胎盘生长因子(Placenta growth factor,PLGF)、甘油三酯葡萄糖(Triglyceride glucoseindex,TyG)指数联合检测对妊娠期糖尿病(Gestational diabetes mellitus,GDM)患者不良妊娠结局的预测价值。方法:选取2020年2月-2022年12月在夏邑县中心医院妇产科产检的132例GDM患者为GDM组,并选择同期132例正常孕妇作为对照组。GDM组患者根据妊娠结局不同分为良好妊娠结局和不良妊娠结局亚组,比较GDM组和对照组及不同妊娠结局GDM患者血清FGF-23、PLGF水平及TyG指数,分析血清FGF-23、PLGF、TyG指数联合检测对GDM患者妊娠结局的预测效能。结果:GDM组血清FGF-23水平及TyG指数高于对照组,血清PLGF水平低于对照组(P<0.05),GDM组发生不良妊娠结局50例,不良妊娠结局发生率为37.88%;不良妊娠结局患者血清FGF-23水平及TyG指数高于良好妊娠结局,血清PLGF水平低于良好妊娠结局(P<0.05),血清FGF-23、PLGF、TyG指数联合检测预测GDM患者不良妊娠结局的AUC、特异度、敏感度分别为0.835、87.12%、86.36%,均高于血清FGF-23、PLGF、TyG指数单独预测指标(P<0.001)。结论:GDF患者的血清FGF-23水平、TyG指数较高,血清PLGF水平较低。血清FGF-23、PLGF水平、TyG指数联合检测对GDF患者的不良妊娠结局有较高的预测价值,临床可根据GDF患者血清FGF-23、PLGF水平及TyG指数,及早进行干预,以减少GDM不良妊娠结局的发生,保障母婴健康。

IMMUNOHISTOCHEMICAL LOCALIZATION OF EPIDERMAL GROWTH FACTOR RECEPTOR AND C-erbB-2 ONCOGENE PRODUCT IN DEVELOPING HUMAN PLACENTA

Cytologic locailzation of epidermai growth factor receptor (EGF-R) and C-erbB2oncogene product in normal developing placenta ovas studied by avidin/biotin immunoperoxidase techniques.Both proteins were predominantly expressed in the villous syncytiotrophoblasts but not in the cytotrophoblasts.The immunoreactive intensity for EGF-R decreased with the development of pregnancy.Concerning the intermediate trophoblasts in cell islands and cell columns,both proteins were more easily detected in the cells distal to the villous stroma than in the juxtastromal cells.These findings suggest that EGF-R and C-erbB-2 may play a significant role in the induction and regulation of differentiated trophoblast function

孕妇血清PLGF水平联合孕妇及胎儿血管参数预测胎儿生长受限

目的 探究孕妇血清胎盘生长因子(PLGF)水平联合孕妇及胎儿血管参数预测胎儿生长受限(FGR)的临床价值。方法 选取60例确诊为FGR的孕妇(FGR组)及60例产前检查健康的孕妇(健康组)。检测孕妇血清PLGF水平(以酶联免疫吸附法)。于孕20~24周对孕妇进行超声检查,检查孕妇子宫动脉(UtA)、胎儿大脑中动脉(MCA)、脐动脉(UA)阻力指数(RI)、搏动指数(PI)、收缩期/舒张期血流比值(S/D)等。绘制受试者工作特征(ROC)曲线评估孕妇血清PLGF水平联合孕妇及胎儿血管参数对FGR的预测价值。行多因素logistic回归分析影响FGR发生的因素。结果 FGR组UtA、UA的RI、PI、S/D明显高于健康组(P<0.05),血清PLGF、MCA的RI、PI、S/D明显低于健康组(P<0.05)。绘制ROC曲线评估血清PLGF联合孕妇及胎儿血管超声参数预测FGR发生的价值,结果显示,UtA-S/D、MCA-PI、UA-RI、UA-PI敏感度较高,PLGF、UA-S/D、MCA-S/D特异度较高,均在90%及以上;行多因素logistic回归分析显示,UtA-RI、UtA-PI、UtA-S/D、MCA-PI、MCA-S/D、UA-RI、UA-PI、UA-S/D、PLGF为影响FGR发生的因素(P<0.05)。结论 FGR孕妇血清PLGF水平较低,母胎血管参数异常,可作为临床预测FGR发生的潜在指标。

Placenta Growth Factor and Soluble Fms-Like Tyrosine Kinase 1 in Preeclampsia and Normotensive Pregnant Nigerian Women

Background: Preeclampsia (PE) is still one of the leading causes of maternal/perinatal morbidity/mortality in Nigeria. Imbalance between placenta growth factor (PLGF) and soluble fms-like tyrosine kinase 1 (sFlt1) has been reportedly present both before and after the manifestation of PE;however, Nigerian data regarding these angiogenesis-related substances are lacking. We here attempted to determine the maternal serum level of PLGF and sFlt1 and sFlt1/PLGF ratio in PE vs. non-PE women in Lagos State University Teaching Hospital, Nigeria. Methods: An observational cross-sectional study was made on 75 women with PE and 75 age-gestational-age matched women without PE, as case and control, respectively. Levels of sFlt-1, PIGF and the sFlt-1: PIGF ratio was compared between the two. Results: Serum levels of Flt-1 and sFlt1/PIGF ratio were significantly higher in PE patients (6581.86 ± 865.75, and 146.42 ± 92.43) than in the normotensive control (4584.52 ± 1479.6 and 11.60 ± 6.42). PIGF was significantly lower in PE patients (70.14 ± 51.03) than the normotensives (494.06 ± 475.8). There were positive and negative correlations between the sFlt-1 and PLGF respectively and mean arterial blood pressure. Conclusion: Serum sFlt-1, sFlt1/PIGF ratio was significantly higher and PIGF levels were significantly lower in PE than normotensive control in Nigerian population.

川芎嗪联合低分子肝素钙对妊娠期子痫前期孕妇sFlt-1、VEGF、PLGF、ET-1水平及妊娠结局的影响

目的:探讨妊娠期子痫前期孕妇采用川芎嗪联合低分子肝素钙治疗对其血清可溶性FMS样酪氨酸激酶-1(Soluble fms-like tyrosine kinase-1,sFlt-1)、血管内皮细胞生长因子(Vascular endothelial growth factor,VEGF)、胎盘生长因子(Placental growth factor,PLGF)、内皮素-1(Endothelin-1,ET-1)水平及妊娠结局的影响。方法:选取2022年1月至2023年1月我院收治的102例妊娠期子痫前期孕妇开展前瞻性研究,将102例孕妇随机分为参照组(51例)、联合组(51例)。参照组采用低分子肝素钙治疗,联合组采用低分子肝素钙+川芎嗪治疗。对比两组治疗前后舒张压、收缩压、平均动脉压、24 h尿蛋白定量、血浆D-二聚体(D-dimer,D-D)、纤维蛋白原(Fibrinogen,FIB)、凝血酶时间(Thrombin time,TT)、凝血酶原时间(Prothrombin time,PT)、血清sFlt-1、VEGF、PLGF、ET-1水平,以及两组终止妊娠孕周、新生儿体质量、Apgar评分、新生儿窒息占比。结果:治疗后联合组舒张压、收缩压、平均动脉压、24 h尿蛋白定量、血浆D-D、FIB、血清sFlt-1、ET-1水平低于治疗前、参照组,血浆TT、PT、血清VEGF、PLGF水平高于治疗前、参照组;联合组终止妊娠孕周长于参照组,新生儿体质量、Apgar评分高于参照组(P<0.05);两组新生儿窒息占比差异无统计学意义。结论:川芎嗪联合低分子肝素钙治疗可降低妊娠期子痫前期孕妇血压水平,减少尿蛋白,改善凝血功能,减轻内皮损伤,从而延长孕周、提高新生儿体质量、Apgar评分,可为临床治疗妊娠期子痫前期提供参考依据。