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探讨复发性自然流产患者子宫动脉血流参数及血清 PLGF 和 sFlt-1 对疗效的评估作用。

Discussion on the evaluation of the therapeutic efficacy of uterine artery blood flow parameters and serum PLGF and sFlt-1 in patients with recurrent spontaneous abortion.

机构信息

Obstetrics and Gynecology Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, 225000, P. R. China.

Reproductive Medicine Centre, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, P. R. China.

出版信息

Reprod Biol Endocrinol. 2024 Sep 28;22(1):119. doi: 10.1186/s12958-024-01289-5.

DOI:10.1186/s12958-024-01289-5
PMID:39342247
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11437999/
Abstract

OBJECTIVE

To investigate the effects of different drug treatments on uterine artery blood flow parameters, serum placental growth factor (PLGF), soluble fms-like tyrosine kinase-1 (sFlt-1), and sFlt-1/PLGF in patients with recurrent spontaneous abortion and to explore the predictive value of uterine artery blood flow parameters, serum PLGF, sFlt-1, and sFlt-1/PLGF for pregnancy outcomes.

METHODS

This retrospective cohort study included 173 patients who experienced recurrent spontaneous abortion and 100 control patients. Patients with recurrent spontaneous abortion were divided into an aspirin group (75 patients), aspirin combined with low molecular weight heparin (LMWH) group (68 patients), and non-drug group (30 patients) based on different drug treatments. Uterine artery blood flow parameters at gestational weeks 30-31 were monitored for the four groups, and serum samples were collected at gestational weeks 30-31 to measure the levels of serum PLGF and sFlt-1 and calculate the sFlt-1/PLGF ratio.

RESULTS

  1. Uterine artery blood flow parameters at gestational weeks 30-31 were significantly greater in the non-drug group than in the aspirin group, combined drug group, and control group (p<0.05). 2. Serum PLGF levels and the sFlt-1/PLGF ratio at gestational weeks 30-31 were significantly lower in the non-drug group than in the aspirin group, combined drug group, and control group, while serum sFlt-1 levels were significantly greater in the non-drug group than in the aspirin group, combined drug group, and control group (p<0.05). 3. Serum PLGF, sFlt-1, and sFlt-1/PLGF had lower diagnostic efficiency for predicting hypertensive disorders during pregnancy than the combined diagnostic efficiency of serum PLGF, sFlt-1, and sFlt-1/PLGF with uterine artery blood flow parameters at gestational weeks 30-31.

CONCLUSION

Aspirin and aspirin combined with LMWH can upregulate serum PLGF and decrease serum sFlt-1 levels in patients with recurrent spontaneous abortion, reduce the miscarriage rate, and significantly improve pregnancy outcomes. The combination of serum PLGF, sFlt-1, sFlt-1/PLGF, and uterine artery blood flow parameters can effectively predict hypertensive disorders during pregnancy.

摘要

目的

探讨不同药物治疗对复发性自然流产患者子宫动脉血流参数、血清胎盘生长因子（PLGF）、可溶性 fms 样酪氨酸激酶-1（sFlt-1）和 sFlt-1/PLGF 的影响，并探讨子宫动脉血流参数、血清 PLGF、sFlt-1 和 sFlt-1/PLGF 对妊娠结局的预测价值。

方法

本回顾性队列研究纳入了 173 例复发性自然流产患者和 100 例对照患者。根据不同的药物治疗，将复发性自然流产患者分为阿司匹林组（75 例）、阿司匹林联合低分子肝素（LMWH）组（68 例）和非药物组（30 例）。监测四组患者妊娠 30-31 周时的子宫动脉血流参数，并在妊娠 30-31 周采集血清样本，检测血清 PLGF 和 sFlt-1 水平，并计算 sFlt-1/PLGF 比值。

结果

  1. 妊娠 30-31 周时，非药物组子宫动脉血流参数明显大于阿司匹林组、联合药物组和对照组（p<0.05）。2. 妊娠 30-31 周时，非药物组血清 PLGF 水平和 sFlt-1/PLGF 比值明显低于阿司匹林组、联合药物组和对照组，而血清 sFlt-1 水平明显高于阿司匹林组、联合药物组和对照组（p<0.05）。3. 血清 PLGF、sFlt-1 和 sFlt-1/PLGF 对预测妊娠高血压疾病的诊断效率低于妊娠 30-31 周时子宫动脉血流参数联合血清 PLGF、sFlt-1 和 sFlt-1/PLGF 的联合诊断效率。

结论

阿司匹林和阿司匹林联合 LMWH 可上调复发性自然流产患者血清 PLGF 水平，降低血清 sFlt-1 水平，降低流产率，显著改善妊娠结局。血清 PLGF、sFlt-1、sFlt-1/PLGF 与子宫动脉血流参数的联合可有效预测妊娠高血压疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e994/11437999/2cf04e9a2c47/12958_2024_1289_Fig9_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e994/11437999/a42a953db32e/12958_2024_1289_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e994/11437999/2cf04e9a2c47/12958_2024_1289_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e994/11437999/9ac53e534ec8/12958_2024_1289_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e994/11437999/bf7171c558a8/12958_2024_1289_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e994/11437999/42b1d6447a3e/12958_2024_1289_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e994/11437999/491eb0729e1c/12958_2024_1289_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e994/11437999/9f309cd7a9db/12958_2024_1289_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e994/11437999/0077b149bea3/12958_2024_1289_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e994/11437999/84faaa691d62/12958_2024_1289_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e994/11437999/a42a953db32e/12958_2024_1289_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e994/11437999/2cf04e9a2c47/12958_2024_1289_Fig9_HTML.jpg

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Prediction of Preeclampsia-Related Adverse Outcomes With the sFlt-1 (Soluble fms-Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor)-Ratio in the Clinical Routine: A Real-World Study.临床常规中 sFlt-1（可溶性 fms 样酪氨酸激酶 1）/PlGF（胎盘生长因子）比值预测子痫前期相关不良结局：一项真实世界研究。
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