Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Shimotsuke-shi, Tochigi, Japan.
Hypertens Res. 2010 May;33(5):422-7. doi: 10.1038/hr.2010.15. Epub 2010 Feb 12.
The first commercial automated immunoassays specific for soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) (Elecsys sFlt-1 and Elecsys PlGF, respectively) have recently been introduced. We constructed reference range values of plasma levels of sFlt-1 and PlGF, and the sFlt-1/PlGF ratio using Elecsys sFlt-1 and Elecsys PlGF during the second half of pregnancy and evaluated their sensitivity and specificity for the diagnosis of preeclampsia. Plasma samples were collected from 144 normal pregnant women at 19-25, 27-31 and 34-38 weeks of gestation and from 34 women with preeclampsia. The most appropriate reference range curves for plasma levels of sFlt-1 and PlGF, and the sFlt-1/PlGF ratio are presented as quadratic curves after logarithmic transformation. The sFlt-1/PlGF ratio showed the best diagnostic power for both early-onset and late-onset preeclampsia. In addition, a cutoff value of 45 for the sFlt-1/PlGF ratio resulted in the best sensitivity and specificity for the diagnosis of all preeclampsia (97 and 95%, respectively), and for the diagnosis of early-onset preeclampsia (100 and 95%, respectively). Using another 50 pairs of serum and plasma samples, including those from normal pregnant women and preeclamptic women, the plasma recovery rates of sFlt-1 and PlGF were 0.89 and 0.85, respectively; the correlation determinations between serum and plasma samples were 0.999 for sFlt-1, 0.990 for PlGF and 0.987 for sFlt-1/PlGF ratio. In conclusion, measurement of the plasma sFlt-1/PlGF ratio determined by Elecsys sFlt-1 and Elecsys PlGF and using a cutoff value of 45 might assist in the diagnosis of preeclampsia, especially for early-onset preeclampsia.
最近推出了第一代用于可溶性 fms 样酪氨酸激酶 1（sFlt-1）和胎盘生长因子（PlGF）的商业化全自动免疫分析试剂盒（Elecsys sFlt-1 和 Elecsys PlGF）。我们使用 Elecsys sFlt-1 和 Elecsys PlGF 构建了妊娠后半期 sFlt-1 和 PlGF 血浆水平以及 sFlt-1/PlGF 比值的参考范围值，并评估了它们对先兆子痫的诊断敏感性和特异性。从 144 名孕 19-25、27-31 和 34-38 周的正常孕妇和 34 名先兆子痫孕妇中采集血浆样本。经过对数转换，sFlt-1 和 PlGF 血浆水平以及 sFlt-1/PlGF 比值的最佳参考范围曲线呈二次曲线。sFlt-1/PlGF 比值对早发型和晚发型先兆子痫均具有最佳的诊断效能。此外，sFlt-1/PlGF 比值的截断值为 45 时，对所有先兆子痫（敏感性和特异性分别为 97%和 95%）和早发型先兆子痫（敏感性和特异性分别为 100%和 95%）的诊断具有最佳的敏感性和特异性。使用另外 50 对血清和血浆样本，包括正常孕妇和先兆子痫孕妇的样本，sFlt-1 和 PlGF 的血浆回收率分别为 0.89 和 0.85；sFlt-1 和 PlGF 血清和血浆样本之间的相关性测定值分别为 0.999、0.990 和 0.987。总之，使用 Elecsys sFlt-1 和 Elecsys PlGF 测定的血浆 sFlt-1/PlGF 比值和 45 的截断值可能有助于先兆子痫的诊断，特别是早发型先兆子痫的诊断。
