Department of Clinical Biochemistry, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Department of Gynecology and Obstetrics, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
BMC Pregnancy Childbirth. 2019 Jul 25;19(1):266. doi: 10.1186/s12884-019-2399-z.
Preeclampsia is a multisystem disorder characterized by vascular endothelial malfunction occurring after 20 weeks of gestation. Placental soluble fms-like tyrosine kinase-1 (sFlt-1) is an antiangiogenic factor and placental growth factor (PlGF) is a potent angiogenic factor. The imbalance between these factors during placenta and fetal development has been shown to play a role in endothelial damage in preeclampsia. Preeclampsia is the leading cause of maternal mortality in Nepal. This study was designed to compare the sFlt1:PLGF ratio in pregnant women with and without preeclampsia attending Tribhuvan University Teaching Hospital (TUTH).
An observational cross-sectional study was performed in the Gynecology and Obstetrics Department of TUTH involving forty-four subjects with preeclampsia and forty-four age- and gestational-week-matched normal pregnant subjects as controls. Blood pressure, urinary protein levels, serum sFlt-1 levels, serum PlGF levels and the sFlt-1:PlGF ratio was compared in both the cases and control. The concentrations of sFlt-1 and PlGF were measured with commercially available ELISA kits. SPSS ver. 20.0 was used to analyze the data.
There was no significant difference in age or gestational age in either study group. The ratio of the sFlt-1 and PlGF concentrations was significantly higher in women with preeclampsia (31.6 ± 9.6) than in the controls (3.2 ± 1.3). Likewise, diastolic blood pressure was significantly associated (p-value 0.000), whereas the severity of proteinuria was not associated (p-value 0.773) with the sFlt-1:PlGF ratio in women with preeclampsia. The significantly higher ratio (35.51 ± 8.1 versus 25.4 ± 8.7) was found in women with preeclampsia who developed complications than the group of women with preeclampsia who did not develop complication.
The sFlt-1:PlGF ratio is significantly higher in Nepalese women with preeclampsia than in normal controls and this finding can be applied for further planned clinical trials.
子痫前期是一种多系统紊乱疾病，其特征为妊娠 20 周后出现血管内皮功能障碍。胎盘可溶性 fms 样酪氨酸激酶-1（sFlt-1）是一种抗血管生成因子，胎盘生长因子（PlGF）是一种有效的血管生成因子。在胎盘和胎儿发育过程中，这些因子的失衡被认为在子痫前期的内皮损伤中起作用。子痫前期是尼泊尔产妇死亡的主要原因。本研究旨在比较在特里布万大学教学医院（TUTH）就诊的子痫前期孕妇和正常孕妇的 sFlt1:PlGF 比值。
在 TUTH 妇产科进行了一项观察性横断面研究，共纳入 44 例子痫前期患者和 44 例年龄和孕龄匹配的正常孕妇作为对照组。比较两组患者的血压、尿蛋白水平、血清 sFlt-1 水平、血清 PlGF 水平和 sFlt-1:PlGF 比值。使用商业 ELISA 试剂盒测量 sFlt-1 和 PlGF 的浓度。使用 SPSS 版本 20.0 分析数据。
两组患者的年龄或孕龄均无显著差异。子痫前期患者的 sFlt-1 和 PlGF 浓度比值（31.6±9.6）明显高于对照组（3.2±1.3）。同样，舒张压与 sFlt-1:PlGF 比值显著相关（p 值 0.000），而蛋白尿的严重程度与子痫前期患者的 sFlt-1:PlGF 比值无相关性（p 值 0.773）。与未发生并发症的子痫前期患者相比，发生并发症的子痫前期患者的比值（35.51±8.1 对 25.4±8.7）明显更高。
尼泊尔子痫前期妇女的 sFlt-1:PlGF 比值明显高于正常对照组，这一发现可用于进一步的临床试验计划。
