Schlembach D, Wallner W, Sengenberger R, Stiegler E, Mörtl M, Beckmann M W, Lang U
Department of Obstetrics and Gynecology, Medical University of Graz, Austria.
Ultrasound Obstet Gynecol. 2007 Apr;29(4):407-13. doi: 10.1002/uog.3930.
To correlate levels of angiogenic growth factors with Doppler ultrasound parameters in pregnancies complicated by pre-eclampsia and intrauterine growth restriction (IUGR).
In 16 women with pre-eclampsia and 15 women with isolated IUGR, pulsatility indices (PI) in the umbilical and uterine arteries were measured by Doppler ultrasonography. At delivery, maternal and fetal blood (umbilical vein and artery separately) was sampled and angiogenic growth factors measured by means of enzyme linked immunosorbent assay (ELISA).
Umbilical artery PI was significantly higher in women with IUGR than in those with pre-eclampsia, whereas uterine artery PI was not statistically significantly different. Maternal soluble fms-like tyrosine kinase-1 (sFlt-1) levels were higher in women with pre-eclampsia than in those with IUGR (P < 0.0001). Umbilical vein basic fibroblast growth factor (bFGF) levels were lower in women with pre-eclampsia than in those with IUGR (P < 0.05). Placental growth factor (PlGF) levels in the umbilical vein were below the detection limit in nearly all samples of IUGR fetuses and lower than in those with pre-eclampsia (P < 0.001). Maternal PlGF levels were inversely correlated with PI values of both vessels. In the umbilical vein sFlt-1 was positively and soluble kinase insert domain receptor (sKDR) negatively correlated with umbilical artery PI. No correlation could be found in the serum of the umbilical artery for all growth factors and for vascular endothelial growth factor (VEGF) in all compartments.
The correlations between maternal and fetal angiogenic growth factor serum levels and Doppler ultrasound indices of uterine and umbilical arteries in pre-eclampsia and IUGR reflect the severity of the disorders especially for the fetus. A combination of both measurements may be useful in future screening for early prediction of pregnancy complications. Published by John Wiley & Sons, Ltd.
探讨子痫前期及胎儿生长受限（IUGR）孕妇血管生成生长因子水平与多普勒超声参数之间的相关性。
对16例子痫前期孕妇和15例单纯IUGR孕妇，采用多普勒超声测量脐动脉和子宫动脉搏动指数（PI）。分娩时，采集母血和胎儿血（分别为脐静脉血和脐动脉血），采用酶联免疫吸附测定（ELISA）法检测血管生成生长因子。
IUGR孕妇脐动脉PI显著高于子痫前期孕妇，而子宫动脉PI差异无统计学意义。子痫前期孕妇母体可溶性fms样酪氨酸激酶-1（sFlt-1）水平高于IUGR孕妇（P<0.0001）。子痫前期孕妇脐静脉碱性成纤维细胞生长因子（bFGF）水平低于IUGR孕妇（P<0.05）。几乎所有IUGR胎儿样本的脐静脉胎盘生长因子（PlGF）水平均低于检测限，且低于子痫前期孕妇（P<0.001）。母体PlGF水平与两条血管的PI值呈负相关。脐静脉中，sFlt-1与脐动脉PI呈正相关，可溶性激酶插入结构域受体（sKDR）与脐动脉PI呈负相关。脐动脉血清中所有生长因子及所有部位的血管内皮生长因子（VEGF）均未发现相关性。
子痫前期及IUGR孕妇母胎血管生成生长因子血清水平与子宫和脐动脉多普勒超声指标之间的相关性反映了疾病的严重程度，尤其是对胎儿而言。两种测量方法结合可能有助于未来对妊娠并发症进行早期预测筛查。由John Wiley & Sons, Ltd.出版
