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可溶性fms样酪氨酸激酶-1(sFLT-1)与胎盘生长因子(PIGF)的比值作为子痫前期严重程度的可能指标——单机构经验

The soluble fms-like tyrosin kinase-1 (sFLT-1) to placental growth factor (PIGF) ratio as a possible indicator for the severity of preeclampsia - single institution experience.

作者信息

Müller Andrijana, Horvat Vesna, Vulin Martina, Mandić Sanja, Šerić Vatroslav, Vidosavljević Domagoj

机构信息

Clinical Department of Gynaecology and Obstetrics, University Hospital Centre Osijek; School of Medicine, J.J. Strossmayer University, Osijek, Croatia.

School of Medicine, J.J. Strossmayer University; Department of Medical Chemistry, Biochemistry and Clinical Chemistry, University Hospital Centre; Osijek, Croatia.

出版信息

Med Glas (Zenica). 2019 Feb 1;16(1):53-59. doi: 10.17392/994-19.

Abstract

Aim To investigate a potential of the clinical use of the soluble fms-like tyrosine kinase 1 (sFLT-1) to placental growth factor (PlGF) ratio from the perspective of a small hospital centre. Methods Maternal serum samples were analysed at 241/7-28 0/7, and 281/7-320/7 weeks of gestation. The level of sFLT-1 and PIGF was determined by immunoassay platform and used to calculate the sFLT-1/PIGF ratio in 35 pregnant women, and divided into subgroups according to preeclampsia occurrence at the time of delivery: preterm (≤37 weeks) or term (37-42 weeks'), and matched a control group. Results Patients in the preterm delivery group had a significantly higher incidence of intrauterine growth restriction, lower gestational age at the time of delivery, and lower infant birth weight compared to the other two groups. There was a negative correlation between the sFLT-1/PlGF ratio and GA and between the sFLT-1/ PlGF ratio and birth weight at the time of delivery. The value of the sFLT-1/PlGF ratio was significantly higher in the preterm delivery PE group. All the PE group pregnancies ended with caesarean delivery compared to 25% in the control group. However, none of the patients from the PE group had any of the possible complications of preeclampsia nor did they require additional therapy such as blood transfusion or additional non-standard hypertensive therapy. Conclusion The sFLT-1/PlGF ratio could be used as an indicator for the development and estimation of the severity of PE to provide objective evidence for the management of preeclampsia patients, and as a predictive marker of preeclampsia at low cost.

摘要

目的 从小医院中心的角度探讨可溶性fms样酪氨酸激酶1(sFLT-1)与胎盘生长因子(PlGF)比值在临床应用中的潜力。方法 在妊娠24 1/7 - 28 0/7周和28 1/7 - 32 0/7周时分析孕妇血清样本。通过免疫分析平台测定sFLT-1和PIGF水平,并用于计算35名孕妇的sFLT-1/PlGF比值,根据分娩时子痫前期的发生情况分为亚组:早产(≤37周)或足月产(37 - 42周),并匹配一个对照组。结果 与其他两组相比,早产组患者宫内生长受限的发生率显著更高,分娩时的孕周更低,婴儿出生体重更低。分娩时sFLT-1/PlGF比值与孕周以及sFLT-1/PlGF比值与出生体重之间存在负相关。早产子痫前期组的sFLT-1/PlGF比值显著更高。与对照组25%的剖宫产率相比,所有子痫前期组的妊娠均以剖宫产结束。然而,子痫前期组的患者均未出现子痫前期的任何可能并发症,也不需要输血或额外的非标准高血压治疗等额外治疗。结论 sFLT-1/PlGF比值可作为子痫前期发生及严重程度评估的指标,为子痫前期患者的管理提供客观依据,且作为子痫前期的预测标志物成本较低。

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