不同程度HPD患者sFlt-1/PlGF、PAPP-A水平及其与不良妊娠结局关系  

Soluble fms-like tyrosine kinase-1/placental growth factor and the pregnancy-associated plasma protein-A level of pregnant women with different degrees of hypertensive disorder complicating pregnancy and their correlation with the daverse pregnancy outcomes

作　　者：蔡巧娥 朱妍依 刘慧 CAI Qiaoe;ZHU Yanyi;LIU Hui(Kunshan Sirth People's Hospital,Suzhou,Jiangsu Province,215321)

机构地区：[1]江苏省昆山市第六人民医院,215321

出　　处：《中国计划生育学杂志》2024年第12期2906-2909,共4页Chinese Journal of Family Planning

摘　　要：目的:分析不同程度妊娠期高血压(HDP)患者可溶性血管内皮生长因子受体1(sFlt-1)/胎盘生长因子(Pl-GF)、妊娠相关血浆蛋白-A(PAPP-A)水平,并探讨与不良妊娠结局关系。方法:收集2021年1月-2023年12月本院就诊治疗的HDP患者88例,根据病情程度分为HDP组(40例)、轻度子痫前期(PE)组(30例)和重度PE组(18例),均检测血清sFlt-1、PlGF、PAPP-A水平并3组对比,Spearman相关性分析sFlt-1/PlGF、PAPP-A水平与HDP病情严重程度关系;根据妊娠结局分为不良组32例和正常组56例,对比两组sFlt-1/PlGF、PAPP-A水平,受试者工作特征(ROC)曲线评估sFlt-1/PlGF、PAPP-A水平对HDP患者不良妊娠结局的预测价值。结果:血清sFlt-1/PlGF、PAPP-A水平在HDP组、轻度PE组、重度PE组依次升高,sFlt-1/PlGF、PAPP-A水平与PE病情严重程度均存在正相关性(r=0.553,r=0.601,均P<0.001)。88例中不良妊娠结局发生率为36.4%。不良组sFlt-1/PlGF、PAPP-A水平高于正常组(P<0.05)。ROC曲线分析,sFlt-1/PlGF、PAPP-A水平及其联合检测预测PE患者不良妊娠结局的曲线下面积分别为0.872、0.867、0.941,敏感度分别为80.0%、87.5%、93.75%,特异度分别为85.2%、73.2%、82.1%,sFlt-1/PlGF联合PAPP-A检测预测效能高于单一指标检测(均P<0.05)。结论:PE患者血清sFlt-1/PlGF、PAPP-A水平与其病情严重程度存在正相关,与不良妊娠结局有关,二者联合检测可提高PE患者不良妊娠结局的预测价值。Objective:To analyze the soluble fms-like tyrosine kinase-1(sFlt-1)/placental growth factor(PIGF)and the pregnancy-associated plasma protein-A level of pregnant women with different degrees of hypertensive disorder complicating pregnancy(HDCP),and to study their correlation with the adverse pregnancy outcomes of the women.Methods:88 pregnant women with HDCP in the hospital were included and were divided group A(40 women with HDCP),group B(30 women with mild preeclampsia)and group C(18 women with severe preeclampsia)according to the severity of HDCP from January 2021 to December 2023.The levels of sFlt-1,PIGF and PAPP-A of the women in the three groups were detected and were compared among the three groups.Spearman correlation analysis was used to analyze the correlation between the sFlt-1/PIGF and the PAPP-A level of the women and their severity of HDCP.According to the pregnancy outcomes of these women,the women were divided into group D(women with adverse pregnancy outcomes)and group E(women with normal pregnancy outcomes),and the sFlt-1/PIGF and the PAPP-A level of the women were compared between the two groups.The value of the sFlt-1/PIGF and the PAPP-A level of the women for predicting their pregnancy outcomes was evaluated by receiver operator characteristic(ROC)curve Results:The serum sFlt-1/PIGF and the PAPP-A level of the women in group A,in group B and in group C had increased gradually,and the sFlt-1/PIGF and the PAPP-A level of the women were positively correlated with their severity of PE(r=0.553,r=0.601,all P<0.001).The incidence of the adverse pregnancy outcomes was 36.4%.The serum sFlt-1/PIGF and the PAPP-A level of the women in group D were significantly higher than those of the women in group E(P<0.05).ROC curve analysis showed that the area under the curve of the sFlt-1/PIGF,the PAPP-A level and the combined sFlt-1/PIGF and PAPP-A level of the women with PE for predicting their adverse pregnancy outcomes were 0.872,0.867 and 0.941,respectively,the sensitivity of which were 80.0%,87.5%and 93.75%

关 键 词：妊娠期高血压疾病 病情程度 可溶性血管内皮生长因子受体1 胎盘生长因子 妊娠相关血浆蛋白-A 不良妊娠结局 相关性 

分 类 号：R714.246[医药卫生—妇产科学]