子宫动脉灌注栓塞治疗胎盘植入的效果及对患者血清VEGF和SFlt-1水平的影响  

Effect of uterine artery embolization on serum VEGF and SFlt-1 levels in placenta accreta patients

作　　者：高素娟[1] 刘彬[2] 曹艳敏[1] 刘会生[2] 

机构地区：[1]河北省沧州市中心医院产三科,沧州061001 [2]河北省沧州市中心医院放射科,沧州061001

出　　处：《广西医科大学学报》2017年第9期1299-1302,共4页Journal of Guangxi Medical University

基　　金：沧州市科技计划基金资助项目(No.162302159)

摘　　要：目的:探讨子宫动脉灌注栓塞治疗胎盘植入(PADs)的临床效果及对患者血管内皮生长因子(VEGF)和可溶性酪氨酸激酶受体-1(SFlt-1)的影响。方法:选择2015年1月至2017年1月河北省沧州市中心医院收治的104例PADs患者,按随机数字表法分为观察组和对照组,每组52例。对照组采用甲氨蝶呤联合清宫术治疗,观察组在对照组治疗的基础上采用子宫动脉栓塞术治疗。观察比较两组治疗效果及血清VEGF、SFlt-1水平变化。结果:观察组胎盘清除时间、清宫术中出血量、β-人体绒膜促性腺激素(β-HCG)转阴时间和住院时间均显著少于对照组(均P<0.05)。两组患者治疗后血清VEGF水平升高,SFlt-1水平降低,且观察组VEGF水平高于对照组,SFlt-1水平低于对照组,差异均有统计学意义(均P<0.05)。观察组治疗后月经恢复时间短于对照组(P<0.05),血浆雌激素(E2)、促卵泡生成素(FSH)、黄体生成素(LH)水平均高于对照组(均P<0.05)。结论:子宫动脉灌注栓塞可有效升高PADs患者血清VEGF水平,降低SFlt-1水平,提高治疗效果,改善预后,具有较好的应用价值。Objectives： To explore the effect of uterine artery embolization on vascular endothelial growth factor （VEGF） and soluble Fms-like tyrosine kinase receptor 1 （SFlt-1） in patients with placental adhesive disorders （PADs）. Methods： 104 PADs patients admitted in our hospital from January 2015 to January 2017 were selected and randomly divided into an observation group and a control groups, with 52 cases in each. Patients in the control group received methotrexate combined with curettage, and patients in the observation group were treated as the con- trol group with addition of uterine artery embolization. The clinical effect and serum levels of VEGF and SFh-1 were observed and compared. Results： The placenta removal time, intraoperative blood loss, B-human chorionic go- nadotropin （^-HCG） clearance time and hospital days in the observation group were significantly lower than those in the control group （P 〈0. 05）. After treatment, the VEGF level in serum was increased, and SFh-1 level was de- creased in both groups （P 〈0. 05）, but the level of SFlt-1 was lower, while VEGF was higher in the observation group than those in the control group （P〈0. 05）. The menstruation recovery time in the observation group was shorter, and the serum levels of estrogen （E2）, follicle-stimulating hormone （FSH） and luteinizing hormone （LH） were significantly higher than than those in the control group （P 〈 0. 05）. Conclusion： Uterine artery emboliza- tion could improve the prognosis and clinical efficacy of patients with PADs by reducing SFlt-1 level and increas- ing VEGF level, which had positive application value.

关 键 词：子宫动脉灌注栓塞 胎盘植入 血管内皮生长因子 可溶性酪氨酸激酶受体-1 

分 类 号：R719[医药卫生—妇产科学]