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sFlt-1/PlGF 比值在<38、38-85 和>85 范围内与围产结局的比较。

The sFlt-1/PlGF ratio values within the <38, 38-85 and >85 brackets as compared to perinatal outcomes.

机构信息

Department of Gynecology and Obstetrics, Pomeranian Medical University, Clinical Hospital nr 2, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland.

Department of Gynecology and Obstetrics, Pomeranian Medical University, Szczecin, Poland.

出版信息

J Perinat Med. 2019 Sep 25;47(7):732-740. doi: 10.1515/jpm-2019-0019.

Abstract

Background Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are used as markers of preeclampsia. The aim of this paper was to assess the correlations between the sFlt-1/PlGF ratio values within the <38, 38-85 and >85 brackets and perinatal outcomes in pregnancies that require determination of these markers. Methods A total of 927 pregnant patients between 18 and 41 weeks' gestation suspected of or confirmed with any form of placental insufficiency (preeclampsia, intrauterine growth restriction [IUGR], gestational hypertension, HELLP syndrome, placental abruption) were included in the study. In each of the patients, the sFlt-1/PlGF ratio was calculated. Patients were divided into three groups according to the sFlt-1/PlGF ratio brackets of <38, 38-85 and >85. Results Significantly worse perinatal outcomes were found in the sFlt-1/PlGF >85 group, primarily with lower cord blood pH, neonatal birth weight and shorter duration of gestation. Statistically significant correlations between the values of these markers and the abovementioned perinatal effects were found. Conclusion An sFlt-1/PlGF ratio value of >85 suggests that either preeclampsia or one of the other placental insufficiency forms may occur, which is associated with lower cord blood pH, newborn weight and earlier delivery. Determining the disordered angiogenesis markers and calculating the sFlt-1/PlGF ratio in pregnancies complicated by placental insufficiency may lead to better diagnosis, therapeutic decisions and better perinatal outcomes.

摘要

背景

可溶性血管内皮生长因子受体 1(sFlt-1)和胎盘生长因子(PlGF)可作为子痫前期的标志物。本文旨在评估 38 周之前、38-85 周之间和 85 周之后这三个不同 sFlt-1/PlGF 比值范围内的比值与需要确定这些标志物的妊娠围产期结局之间的相关性。

方法

共纳入 927 例 18-41 孕周疑似或确诊存在胎盘功能不全(子痫前期、胎儿宫内生长受限、妊娠期高血压、HELLP 综合征、胎盘早剥)的孕妇,计算每位患者的 sFlt-1/PlGF 比值,并根据 sFlt-1/PlGF 比值范围将患者分为<38、38-85 和>85 三个组。

结果

sFlt-1/PlGF>85 组的围产结局明显较差,主要表现为脐血 pH 值较低、新生儿出生体重较轻和妊娠时间较短。这些标志物的数值与上述围产结局之间存在显著的相关性。

结论

sFlt-1/PlGF 比值>85 提示可能存在子痫前期或其他一种胎盘功能不全形式,与脐血 pH 值较低、新生儿体重较轻和分娩较早相关。在胎盘功能不全的妊娠中检测血管生成标志物紊乱并计算 sFlt-1/PlGF 比值,可能有助于更好地诊断、制定治疗决策并改善围产结局。

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