子痫前期患者循环PLGF水平对预测病情及评估母婴结局的价值初探  

Preliminary study on the value of circulating PLGF level in predicting the severity of preeclampsia and evaluating pregnancy outcome

作　　者：盛红娜[1] 范卓然 华绍芳[1] 张俊农[1] SHENG Hongna;FAN Zhuoran;HUA Shaofang;ZHANG Junnong(Department of Obstetrics,the Second Hospital of Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]天津医科大学第二医院产科,300211

出　　处：《天津医药》2024年第6期630-634,共5页Tianjin Medical Journal

基　　金：天津市卫生健康科技项目(ZC20057)。

摘　　要：目的探讨循环胎盘生长因子(PLGF)水平与子痫前期(PE)病情程度及母婴结局、胎盘病理学改变的相关性。方法选取PE患者159例为研究对象,根据终止妊娠孕周分为:PE_(1)组(62例,<34周终止妊娠的PE患者)和PE_(2)组(97例,≥34周终止妊娠的PE患者);选取同期分娩的107例非PE患者作为对照,根据终止妊娠孕周分为:非PE_(1)组(41例,<34周终止妊娠的非PE患者),非PE_(2)组(66例,≥34周终止妊娠的非PE患者)。收集各组孕妇一般资料:年龄、体质量指数(BMI)、入院收缩压、舒张压,24 h尿蛋白定量、孕产次、是否存在胎儿生长受限(FGR)、胎儿宫内窘迫。新生儿一般资料:术中记录是否有羊水粪染、新生儿窒息,新生儿入住新生儿重症监护病房(NICU)天数;检测分娩当日孕妇静脉血PIGF;将患者胎盘行病理检测并评分;胎儿娩出后行脐动脉血气分析并记录酸碱度(p H)、碱剩余(BE)、乳酸(LAC)。结果PE_(1)组和PE_(2)组与相应孕周非PE_(1)和非PE_(2)组年龄、孕次、产次差异无统计学意义;PE_(1)组与PE_(2)组BMI分别高于非PE_(1)、非PE_(2)组,PLGF分别低于非PE_(1)、非PE_(2)组,且PE_(1)组PLGF低于PE_(2)组(P<0.05)。PE_(1)组患者24 h尿蛋白定量、收缩压、舒张压、胎盘异常病理改变评分高于PE_(2)组(P<0.05)。PE_(1)组与PE_(2)组产时羊水粪染、胎儿宫内窘迫情况、脐动脉血p H值差异无统计学意义,与PE_(2)组比较,PE_(1)组新生儿窒息及FGR比例、脐动脉血LAC升高,BE值降低,入住NICU时间延长(P<0.05)。结论PE患者循环PLGF水平降低,PLGF水平在PE病情评估、预测不良妊娠结局方面有一定价值。Objective To investigate the correlation between the level of circulating placental growth factor(PLGF)and the severity of preeclampsia(PE),maternal and infant outcomes and placental pathology.Methods A total of 159 PE patients were selected as the study subjects and divided into the PE_(1) group(62 PE patients with termination of pregnancy<34 weeks)and the PE_(2) group(97 PE patients with termination of pregnancy≥34 weeks)according to the gestational age of pregnancy termination.A total of 107 non-PE patients who gave birth during the same period were selected as the control group.Patients were divided into two groups according to the gestational age of termination:the non-PE_(1) group(41 non-PE patients with termination of pregnancy at<34 weeks)and the non-PE_(2) group(66 non-PE patients with termination of pregnancy at≥34 weeks).General data were collected in each group of pregnant women,including age,body mass index(BMI),admission systolic blood pressure,diastolic blood pressure,24 h urinary protein quantity,gestational times,presence of FGR and fetal embarrassment.General information of newborns during the operation were collected,for example,whether there was fecal contamination of amniotic fluid,neonatal asphyxia,and days of newborn stayed in NICU.PLGF in venous blood of pregnant women was detected on the day of delivery.The placenta was pathologically detected and scored.After delivery,blood gas of umbilical artery was analyzed,and PH(pH),base surplus(BE),lactic acid(LAC)were recorded.Results There were no significant differences in age,gestational times and delivery times between the PE_(1) group and the PE_(2) group and the corresponding the non-PE_(1) group and the non-PE_(2) group.BMI was higher in the PE_(1) group and the PE_(2) group than that in the non-PE_(1) group and the non-PE_(2) group.PLGF was lower in the PE_(1) group and the PE_(2) group than that in the non-PE_(1) group and the non-PE_(2) group,respectively,and PLGF was lower in the PE_(1) group than that in the PE_(2) group(P<0.05).Th

关 键 词：胎盘生长因子 妊娠结局 胎盘 先兆子痫 

分 类 号：R714.244[医药卫生—妇产科学]