子痫前期作为妊娠期高血压疾病(hypertensive disorders of Pregnancy,HDP)家族成员中的一种,是造成孕产妇产后大出血、胎盘早剥、胎儿生长发育受限等不好孕育结果的主要因素之一。作为一种多种因素共同致病的疾病,子痫前期的发病机制...子痫前期作为妊娠期高血压疾病(hypertensive disorders of Pregnancy,HDP)家族成员中的一种,是造成孕产妇产后大出血、胎盘早剥、胎儿生长发育受限等不好孕育结果的主要因素之一。作为一种多种因素共同致病的疾病,子痫前期的发病机制还未达成共识。近年来,更多的临床实验结果表明:在患有子痫或子痫前期的妊娠妇女血液标本中,包括了胎盘生长因子(placental growth factor,PLGF)、可溶性Fms样酪氨酸激酶-1(soluble fms-like tyrosin e kinase-1,sFlt-1)在内的多种生物标志物,存在着较正常未患病孕妇更为明显的浓度变化。本文主要针对sFlt-1、PLGF及其比值与子痫前期的相关关系进行综述。展开更多
The purpose of this study was to determine if an elevated concentration of soluble fms-like tyrosine kinase- 1(sFlt- 1) in maternal plasma and amniotic fluid is a risk factor for the subsequent development of preeclam...The purpose of this study was to determine if an elevated concentration of soluble fms-like tyrosine kinase- 1(sFlt- 1) in maternal plasma and amniotic fluid is a risk factor for the subsequent development of preeclampsia. Study design: A case-control study was conducted to compare mid-trimester concentrations of maternal plasma and amniotic fluid sFlt- 1 in patients who developed preeclampsia with those who did not. The study included 32 cases with preeclampsia (18 cases: severe preeclampsia) and 128 matched controls with normal outcomes. Patients with an abnormal fetal karyotype or major anomaly, multiple pregnancies, chronic hypertension, diabetes, and renal disease were excluded. Soluble Flt- 1 concentration was measured by specific immunoassay. Nonparametric techniques were used for statistical analysis. Results: 1)The median maternal plasma, but not amniotic fluid, sFlt- 1 concentration in patients who developed preeclampsia was significantly higher than in the control cases (maternal plasma: median 730 pg/mL, range 60- 3375 pg/mL vs median 441 pg/mL, range 58- 1959 pg/mL, P < .05; amniotic fluid: median 10,504 pg/mL, range 5253- 38,023 pg/mL vs median 10,236 pg/mL, range 4326- 87,684 pg/mL, P = .65). 2) The median plasma concentration of sFlt- 1 was higher in cases of severe preeclampsia than in those with mild preeclampsia without reaching statistical significance (median 762 pg/mL, range 261- 3309 pg/mL vs median 334 pg/mL, range 60- 3375 pg/mL; P = .07). However, there was no significant difference in the median amniotic fluid sFlt- 1 concentrations between patients with severe preeclampsia and those with mild preeclampsia (P = .45). 3) An elevated maternal plasma sFlt- 1 concentration (higher than 700 pg/mL) is a risk factor for the development of preeclampsia (OR 3.9, 95% CI 1.7- 8.6) and severe preeclampsia (OR 7.4, 95% CI 2.5- 22.1) after genetic amniocentesis. 4) The median interval from amniocentesis to the diagnosis of preeclampsia in patients with maternal plasma sFlt- 1 concentrations higher than 700 pg/mL was 117 days (range 19- 154 days). Conclusion: An elevated concentration of sFlt- 1 in maternal plasma at the time of mid-trimester amniocentesis is a risk factor for the subsequent development of preeclampsia.展开更多
文摘目的:探讨胎盘生长因子(placental growth factor,PLGF)、可溶性fms样酪氨酸激酶-1(soluble fms-like tyrosine kinase-1,SFLT-1)和糖基化纤连蛋白(glycosylated fibronectin,GLYFN)检测对子痫前期的预测价值。方法:选择在无锡市妇幼保健院就诊的188例孕妇,分154例正常孕妇(对照组)和34例子痫前期患者(子痫组),应用免疫荧光法分别检测其在孕16~18周血清中PLGF、SFLT-1和GLYFN的浓度,比较子痫前期组和对照组各标志物的水平,并使用受试者操作特征曲线(receiver operating characteristic,ROC)对3种标志物的预测价值进行效能评估。结果:在妊娠中期,子痫前期组血清PLGF浓度低于对照组,SFLT-1及GLYFN浓度均高于对照组,3种标志物的差异均有统计学意义(3指标P=0.000)。95%置信区间的ROC曲线下面积(areas under the ROC curve,AUC)为,PLGF为0.941(0.907~0.974),SFLT-1为0.881(0.800~0.962),GLYFN为0.951(0.918~0.985),联合指标SFLT-1和GLYFN、3项指标联合检测在ROC曲线下面积(areas under the ROC curve,AUC)分别为0.968、0.986。结论:PLGF、SFLT-1、GLYFN 3种标志物水平在对照组和子痫前期组均存在明显差异,对子痫前期的发病具有一定的预测价值,SFLT-1联合PLGF、SFLT-1联合GLYFN、3项指标联合检测对子痫前期的预测价值高于任一单项指标。
文摘子痫前期作为妊娠期高血压疾病(hypertensive disorders of Pregnancy,HDP)家族成员中的一种,是造成孕产妇产后大出血、胎盘早剥、胎儿生长发育受限等不好孕育结果的主要因素之一。作为一种多种因素共同致病的疾病,子痫前期的发病机制还未达成共识。近年来,更多的临床实验结果表明:在患有子痫或子痫前期的妊娠妇女血液标本中,包括了胎盘生长因子(placental growth factor,PLGF)、可溶性Fms样酪氨酸激酶-1(soluble fms-like tyrosin e kinase-1,sFlt-1)在内的多种生物标志物,存在着较正常未患病孕妇更为明显的浓度变化。本文主要针对sFlt-1、PLGF及其比值与子痫前期的相关关系进行综述。
文摘The purpose of this study was to determine if an elevated concentration of soluble fms-like tyrosine kinase- 1(sFlt- 1) in maternal plasma and amniotic fluid is a risk factor for the subsequent development of preeclampsia. Study design: A case-control study was conducted to compare mid-trimester concentrations of maternal plasma and amniotic fluid sFlt- 1 in patients who developed preeclampsia with those who did not. The study included 32 cases with preeclampsia (18 cases: severe preeclampsia) and 128 matched controls with normal outcomes. Patients with an abnormal fetal karyotype or major anomaly, multiple pregnancies, chronic hypertension, diabetes, and renal disease were excluded. Soluble Flt- 1 concentration was measured by specific immunoassay. Nonparametric techniques were used for statistical analysis. Results: 1)The median maternal plasma, but not amniotic fluid, sFlt- 1 concentration in patients who developed preeclampsia was significantly higher than in the control cases (maternal plasma: median 730 pg/mL, range 60- 3375 pg/mL vs median 441 pg/mL, range 58- 1959 pg/mL, P < .05; amniotic fluid: median 10,504 pg/mL, range 5253- 38,023 pg/mL vs median 10,236 pg/mL, range 4326- 87,684 pg/mL, P = .65). 2) The median plasma concentration of sFlt- 1 was higher in cases of severe preeclampsia than in those with mild preeclampsia without reaching statistical significance (median 762 pg/mL, range 261- 3309 pg/mL vs median 334 pg/mL, range 60- 3375 pg/mL; P = .07). However, there was no significant difference in the median amniotic fluid sFlt- 1 concentrations between patients with severe preeclampsia and those with mild preeclampsia (P = .45). 3) An elevated maternal plasma sFlt- 1 concentration (higher than 700 pg/mL) is a risk factor for the development of preeclampsia (OR 3.9, 95% CI 1.7- 8.6) and severe preeclampsia (OR 7.4, 95% CI 2.5- 22.1) after genetic amniocentesis. 4) The median interval from amniocentesis to the diagnosis of preeclampsia in patients with maternal plasma sFlt- 1 concentrations higher than 700 pg/mL was 117 days (range 19- 154 days). Conclusion: An elevated concentration of sFlt- 1 in maternal plasma at the time of mid-trimester amniocentesis is a risk factor for the subsequent development of preeclampsia.
