先兆子痫发生的危险因素及血清VEGFR-1、PLGF对先兆子痫的预测价值  

Risk ractors for the occurrence of preeclampsia and the predictive value of serum VEGFR-1 and PLGF for preeclampsia

作　　者：邹小玲[1] 刘淼[1] 王永红[1] Zou Xiaoling;Liu Miao;Wang Yonghong(Department of Obstetrics,The First People′s Hospital of Chenzhou,Chenzhou 423000,China)

机构地区：[1]郴州市第一人民医院产科,郴州423000

出　　处：《中国医师杂志》2023年第6期880-885,共6页Journal of Chinese Physician

基　　金：2021年度湘南学院校级课题(2021XJ138)。

摘　　要：目的探究先兆子痫发生的危险因素及血清血管内皮生长因子受体-1(VEGFR-1)与胎盘生长因子(PLGF)对先兆子痫(PE)的预测价值。方法回顾性选取2020年1月至2022年1月期间于郴州市第一人民医院行产前检查并最终确诊为PE的148例孕妇作为PE组,并选取与PE组同时期进行产前检查的148例健康孕妇为对照组。比较两组孕妇VEGFR-1、PLGF、VEGFR-1/PLGF水平,logistic回归分析PE的危险因素,分析VEGFR-1、PLGF、VEGFR-1/PLGF与危险因素的相关性,受试者工作特征(ROC)曲线分析VEGFR-1、PLGF、VEGFR-1/PLGF对PE的预测价值并获取截断值,根据截断值绘制孕妇发生PE的生存曲线。结果PE组VEGFR-1、VEGFR-1/PLGF水平高于对照组(均P<0.05),PLGF水平低于对照组(P<0.05)。Logistic回归分析结果显示,年龄、BMI、妊娠期高血压、妊娠期糖尿病、高血压家族史、子痫前期史、VEGFR-1和VEGFR-1/PLGF为PE的危险因素(均P<0.05),PLGF是PE的保护因素(P<0.05)。VEGFR-1、VEGFR-1/PLGF与年龄、BMI、妊娠期高血压、妊娠期糖尿病、高血压家族史、子痫前期史均呈正相关(均P<0.001),PLGF与年龄、BMI、妊娠期高血压、妊娠期糖尿病、高血压家族史、子痫前期史均呈负相关(均P<0.001)。VEGFR-1、PLGF、VEGFR-1/PLGF对PE的预测价值较高(AUC=0.773、0.791、0.825),截断值分别为9190.83 ng/L、508.17 ng/L、21.64。根据截断值将296例孕妇分为低、中、高风险3组,生存分析结果显示三组发生PE的概率分别为1.36%、18.97%、66.67%。结论VEGFR-1与PLGF对PE的预测价值较高,临床可通过监测VEGFR-1/PLGF水平并联合其他检查手段提高PE诊断和预测的准确性,改善妊娠结局。Objective To explore the risk factors for the occurrence of preeclampsia(PE)and the predictive value of serum vascular endothelial growth factor receptor-1(VEGFR-1)and placental growth factor(PLGF)for PE.Methods A retrospective study was conducted to select 148 pregnant women who underwent prenatal examinations at the First People′s Hospital of Chenzhou from January 2020 to January 2022 and were ultimately diagnosed with PE as the PE group,and 148 healthy pregnant women who underwent prenatal examinations during the same period as the PE group were selected as the control group.The levels of VEGFR-1,PLGF,and VEGFR-1/PLGF were compared between two groups of pregnant women.Logistic regression analysis was performed on the risk factors for PE,and the correlation between VEGFR-1,PLGF,VEGFR-1/PLGF and risk factors was analyzed.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of VEGFR-1,PLGF,and VEGFR-1/PLGF for PE and obtain cutoff values.The survival curve of pregnant women with PE was plotted based on the cutoff values.Results The levels of VEGFR-1 and VEGFR-1/PLGF in the PE group were higher than those in the control group(all P<0.05),while the levels of PLGF were lower than those in the control group(P<0.05).Logistic regression analysis showed that age,body mass index(BMI),pregnancy induced hypertension,pregnancy induced diabetes,family history of hypertension,preeclampsia,VEGFR-1 and VEGFR-1/PLGF were risk factors for PE(all P<0.05),and PLGF was a protective factor for PE(P<0.05).VEGFR-1,VEGFR-1/PLGF were positively correlated with age,BMI,pregnancy induced hypertension,pregnancy induced diabetes,hypertension family history,and PE(all P<0.001),while PLGF was negatively correlated with age,BMI,pregnancy induced hypertension,pregnancy induced diabetes,hypertension family history,and preeclampsia(all P<0.001).VEGFR-1,PLGF,and VEGFR-1/PLGF had higher predictive value for PE(AUC=0.773,0.791,0.825),with cutoff values of 9190.83 ng/L,508.17 ng/L,and 21.64,respectively.According

关 键 词：先兆子痫 血管内皮生长因子受体1 胎盘生长因子 危险因素 

分 类 号：R714.244[医药卫生—妇产科学]