可溶性血管内皮生长因子受体1对子痫前期的早期预测价值  

Predictive value of serum soluble fms-like tyrosine kinase 1 concentration in preeclampsia at second trimester

作　　者：叶元华[1] 刘玲[1] 詹瑛[1] 彭伟[1] 

机构地区：[1]青岛大学医学院附属医院妇产科,266003

出　　处：《中华妇产科杂志》2006年第7期433-435,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的探讨血清可溶性血管内皮生长因子受体1(sFlt-1)水平变化对子痫前期的早期预测价值。方法采用酶联免疫吸附法检测172例妊娠26～28周孕妇的血清sFlt-1及血管内皮生长因子(VEGF)水平,并随访至分娩,其中16例发展为子痫前期(子痫前期组),另外156例正常妊娠者为对照组。结果子痫前期组患者血清sFlt-1、VEGF分别为(11．4±6．2)μg/L、(26±4)ng/L,对照组分别为(4．5±2．1)μg/L、(29±4)ng/L,两组sFlt-1水平比较,差异有统计学意义(P＜0．01)；两组VEGF水平比较,差异无统计学意义(P＞0．05)。伴胎儿生长受限的子痫前期患者(8例)及妊娠32周前发病的子痫前期患者(6例)血清sFlt-1水平分别为(14．0±6．8)、(14．4±6．7)μg/L,均分别明显高于未伴胎儿生长受限及妊娠32周后发病的子痫前期患者的(9．0±4．1)、(8．9±4．0)μg/L,差异有统计学意义(P＜0．05)。以sFlt-1水平8．75μg/L为界限值,预测子痫前期的敏感度为87．5%,特异度为97．4%,阳性预测值为80．0%,阴性预测值为88．5%。结论血清sFlt-1水平可作为子痫前期发病的早期预测指标。Objective To explore the predictive value of serum soluble fms-like tyrosine kinase-1 （sFlt-1） and vascular endothelia growth factor （VEGF） levels in preeclampsia at second trimester. Methods Serum sFlt-1, VEGF concentrations were determined in 172 initial normal pregnant women at 26 -28 gestation week. The outcomes of pregnancies were followed. In a cohort of 172 pregnant women, 16 cases of preeclampsia were developed （preeclampsia group） , and 156 cases were with no complication （control group）. Results The serum levels of sFlt-1 in preeclampsia group （11.4 ±6. 2 ） μg/L were significantly higher than that in control group（4. 5 ± 2. 1 ） μg/L （P 〈 0. 01 ）. The serum levels of sFlt-1 in precelampsia women with the onset before 32 gestation week and fetal growth retardation, （ 14. 0 ± 6. 8 ） μg/L, （ 14.4 ± 6. 7） μg/L were significantly higher than that in women with the onset after 32 gestation week and with no fetal growth retardation （ 9. 0 ± 4. 1 ） μg/L, （ 8. 9 ± 4. 0） μg/L, respectively （ P 〈 0. 05 ）. There was no significant difference in the serum levels of VEGF between preeclampsia group and control group. A sFlt-1 cutoff value of 8.75 μg/L at 26 - 28 gestation week yielded a sensitivity of 87. 5% , specificity of 97.4% , positive predictive value of 80. 0% , negative predictive value of 88. 5% , respectively, for subsequent onset of preeclampsia. Conclusion Maternal serum sFlt-1 concentration at second trimester can be used as an early predictive marker of preeclampsia.

关 键 词：子痫前期 血管内皮生长因子 受体 

分 类 号：R714.2[医药卫生—妇产科学]