不同孕期胎盘生长因子和血管内皮生长因子水平与胎儿生长受限发生风险的关联分析  

The Correlation of Serum Levels of Placental Growth Factor and Vascular Endothelial Growth Factor in Different Trimesters with The Risk of Fetal Growth Restriction

作　　者：刘兆敏 蒲元林 吴慧捷 李丽 LIU Zhaomin;PU Yuanlin;WU Huijie;LI Li(Department of Neonatology,Minda Hospital Affiliated to Hubei University for Nationalities,Enshi 445000,China;Department of Neonatology and Child Intensive Medicine,The Central Hospital of Enshi Tujia and Miao Autonmous Prefecture,Enshi 445000,China;Minda Hospital Affiliated to Hubei University for Nationalities,Enshi 445000,China)

机构地区：[1]湖北民族大学附属民大医院新生儿科,恩施445000 [2]湖北省恩施土家族苗族自治州中心医院新生儿科,恩施445000 [3]湖北民族大学附属民大医院产科,恩施445000

出　　处：《福建医科大学学报》2020年第5期333-338,共6页Journal of Fujian Medical University

基　　金：风湿性疾病发生与干预湖北省重点实验室第三批(2017年度)开放基金项目(OIR17014A)。

摘　　要：目的评估不同孕期孕妇血清胎盘生长因子(PlGF)和血管内皮生长因子(VEGF)的表达水平及其与胎儿生长受限(FGR)发生风险的关系。方法纳入妊娠8周内行产前检查的326例孕妇,分别于孕早期(妊娠≤13周)、孕中期(妊娠14~27周)和孕晚期(妊娠≥28周)在孕妇空腹且静息状态下采集外周血,冻存统一分离血清后,采用酶联免疫吸附实验检测血清中PlGF和VEGF的水平。根据《妇产科学》第8版教材中的诊断标准进行FGR的诊断,并将孕妇分为FGR组(n=32)和正常妊娠组(n=294)。结果326例孕妇中,孕中、晚期血清PlGF和VEGF的表达水平低于孕早期,差别有统计学意义(P<0.001)。PlGF与VEGF在孕早期、孕中期和孕晚期均呈正相关(P<0.001)。孕早期FGR组与正常妊娠组比较,PlGF和VEGF无显著差别(P>0.05),但孕中期和孕晚期FGR组的PlGF和VEGF均显著低于正常妊娠组(均P<0.001)。受试者工作特征曲线分析显示,孕中期和孕晚期PlGF均对FGR的发生风险具有较好的预测作用,其中孕晚期PlGF的预测作用最好,其曲线下面积(AUC)为0.900(95%CI:0.845~0.955);孕中期和孕晚期VEGF对FGR的发生风险同样具有较好的预测作用,其中孕晚期VEGF的预测作用最好,其AUC为0.861(95%CI:0.801~0.920)。结论孕妇血清孕中期和孕晚期的PlGF和VEGF表达水平均可以预测FGR的发生风险,其中孕晚期血清PlGF和VEGF的表达水平对FGR发生风险的预测作用最强。Objective To evaluate the serum levels of placental growth factor(PlGF)and vascular endothelial growth factor(VEGF)in different trimesters in pregnancy,and their values for predicting FGR.Methods Three hundred and twenty-six pregnant women who underwent prenatal examination within 8 weeks of pregnancy were included in this study.Fasting peripheral blood samples were collected from each subject at resting state in the first,second and third trimesters,and serum was separated for PlGF and VEGF detections by enzyme-linked immunosorbent assay.The FGR diagnosis was made based on the diagnostic criteria according to the eighth edition of Obstetrics and Gynecology,and the pregnant women were divided into FGR patients and normal pregnant women.The serum levels of PlGF and VEGF were detected by enzyme-linked immunosorbent assay.Results Serum levels of PlGF and VEGF were decreased in the second and third trimesters compared to those in the first trimester in all the pregnant women in our study(all P<0.001).In addition,PlGF expression was positively correlated with VEGF expression in the first,second and third trimesters(all P<0.001).No difference of PlGF and VEGF expressions was found between FGR patients and normal pregnant women at the first trimester(P>0.05),however,PlGF and VEGF expressions in FGR patients were decreased compared to normal pregnant women in the second and third trimesters(all P<0.001).The receiver operating characteristics(ROC)curve analyses revealed that PlGF expression in the second and third trimesters had good value in predicting the FGR risk with the value of PlGF expression in the third trimester being the best,and its area under the ROC(AUC)was 0.900(95%CI:0.845-0.955);similarly,VEGF expression in the second and third trimesters also had good values in predicting FGR risk,and VEGF expression in the third trimester had the best value with an AUC of 0.861(95%CI:0.801-0.920).Conclusion PlGF and VEGF levels in the second and third trimesters are downregulated compared with the first trimester,and Pl

关 键 词：胎儿发育 胞间信号肽类和蛋白质类 胎盘 血管内皮生长因子类 妊娠初期 妊娠中期 妊娠末期 

分 类 号：R321.58[医药卫生—人体解剖和组织胚胎学] R714[医药卫生—基础医学]