Tardif C, Dumontet E, Caillon H, Misbert E, Dochez V, Masson D, Winer N
Department of Gynecology and Obstetrics, Nantes University Hospital, CIC Mère enfant, 38, boulevard Jean-Monnet, 44093 Nantes, France.
Hormonology and Biochemistry Laboratory, CHU of Nantes, 38, boulevard Jean-Monnet, 44093 Nantes, France.
J Gynecol Obstet Hum Reprod. 2018 Jan;47(1):17-21. doi: 10.1016/j.jogoh.2017.10.007. Epub 2017 Nov 2.
Despite its simple definition, preeclampsia can have variable and atypical clinical presentations, an unpredictable course, and potential adverse maternal and fetal outcomes. No single test currently predicts risk or prognosis adequately. Scientific advances suggest that an angiogenic imbalance is involved in its pathophysiology. The objective of this study was to investigate the use of sFlt-1, PlGF, and their ratio in predicting preeclampsia.
In a single-center prospective observational study, we measured the angiogenic markers sFlt-1 and PlGF and calculated the sFlt-1/PlGF ratio in patients at risk of preeclampsia at 20 to 37 weeks of gestation. The main outcomes were the occurrence of preeclampsia and the interval before its onset.
Of the 67 at risk patients included, 8 (12%) developed preeclampsia. For a sFlt-1/PlGF ratio ≥85, the specificity was 93%. The ratio was significantly higher (ratio=104±30) in women with an onset time less than 5 weeks than in those with later preeclampsia (ratio=10±2), P<0.001.
In a high-risk population, angiogenic markers appear to be an interesting aid in predicting the onset of preeclampsia with high specificity and in estimating time to onset. However, due to small number of cases of PE, more studies are needed before recommendations to use these markers in daily practice.
尽管子痫前期的定义简单，但其临床表现可能多样且不典型，病程不可预测，对母婴有潜在不良结局。目前尚无单一检测方法能充分预测风险或预后。科学进展表明血管生成失衡参与其病理生理过程。本研究的目的是探讨可溶性血管内皮生长因子受体-1（sFlt-1）、胎盘生长因子（PlGF）及其比值在预测子痫前期中的应用。
在一项单中心前瞻性观察研究中，我们测量了子痫前期风险患者在妊娠20至37周时的血管生成标志物sFlt-1和PlGF，并计算sFlt-1/PlGF比值。主要结局是子痫前期的发生及其发病前的间隔时间。
纳入的67例风险患者中，8例（12%）发生子痫前期。对于sFlt-1/PlGF比值≥85，特异性为93%。发病时间小于5周的女性该比值（比值 = 104±30）显著高于子痫前期发病较晚的女性（比值 = 10±2），P<0.001。
在高危人群中，血管生成标志物似乎有助于以高特异性预测子痫前期的发病并估计发病时间。然而，由于子痫前期病例数较少，在推荐将这些标志物用于日常实践之前还需要更多研究。
