自动化检测 sVEGF R1 和 PlGF 对早产子痫前期的辅助诊断作用：一项前瞻性临床研究。

Automated assays for sVEGF R1 and PlGF as an aid in the diagnosis of preterm preeclampsia: a prospective clinical study.

机构信息

Department of Maternal-Fetal Medicine, The Toledo Hospital, OH 43606, USA.

出版信息

Am J Obstet Gynecol. 2010 Jan;202(1):40.e1-7. doi: 10.1016/j.ajog.2009.07.025. Epub 2009 Sep 17.

DOI:10.1016/j.ajog.2009.07.025

PMID:19762001

Abstract

OBJECTIVE

The purpose of this study was to assess the utility of soluble vascular endothelial growth factor 1 (sVEGF R1) and placental growth factor (PlGF) levels in the clinical diagnosis of preeclampsia.

STUDY DESIGN

Plasma was collected prospectively from 457 subjects (n = 409 without preeclampsia, n = 48 with preeclampsia) at 20-36 weeks' gestation. Automated immunoassays were used to measure free sVEGF R1 and free PlGF.

RESULTS

Clinical sensitivities of 0.96 and specificities of 0.96 and 0.95 were calculated for sVEGF R1 and PlGF, respectively, for aiding in the diagnosis of preeclampsia. Among subjects with chronic hypertension, sVEGFR1 was dramatically elevated and PlGF decreased in those with superimposed preeclampsia (P < .001 for superimposed preeclampsia vs chronic hypertension for both biomarkers). The ratio of sVEGFR1/PlGF provided a better test to aid in the diagnosis of preeclampsia than either analyte alone (3% false positive rate).

CONCLUSION

Free sVEGF R1 and PlGF were useful in differentiating women with preterm preeclampsia from normotensive and hypertensive subjects.

摘要

目的

本研究旨在评估可溶性血管内皮生长因子 1（sVEGF R1）和胎盘生长因子（PlGF）水平在子痫前期临床诊断中的应用价值。

研究设计

在 20-36 孕周时，前瞻性采集 457 例受试者（n=409 例无子痫前期，n=48 例子痫前期）的血浆。采用自动化免疫分析法检测游离 sVEGF R1 和游离 PlGF。

结果

sVEGF R1 和 PlGF 分别用于子痫前期辅助诊断的临床灵敏度为 0.96，特异度为 0.96 和 0.95。在慢性高血压患者中，叠加子痫前期患者的 sVEGFR1 显著升高，PlGF 降低（对于叠加子痫前期 vs 慢性高血压，两种生物标志物均 P<.001）。sVEGFR1/PlGF 比值用于子痫前期辅助诊断的效果优于单一分析物（假阳性率为 3%）。