可溶性血管内皮生长因子受体-1、凝血功能及血小板作为子痫前期的预测指标
sFlt-1, Coagulation Function, and Platelets as Predictors of Preeclampsia.
作者信息
Yuan Jiani, Wu Duanqing, Ye Jun, Chen Rujun, Wang Xiaoqin, Zhang Liwen
机构信息
Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
出版信息
J Obstet Gynaecol Can. 2025 Mar;47(3):102772. doi: 10.1016/j.jogc.2025.102772. Epub 2025 Jan 28.
OBJECTIVE
To investigate the predictive value of soluble FMS-like tyrosine kinase-1 (sFlt-1), coagulation function, and platelet (PLT) parameters for preeclampsia (PE).
METHODS
A prospective study was conducted on women registered and delivered at Shanghai Fifth People's Hospital from October 2020 to December 2021. All eligible pregnant women were recruited at the time of initial registration in the first trimester. We then obtained serum samples uniformly at 24-28 weeks and stored these samples in a freezer at -80°C and labelled them to create a biobank. Later, when PE was diagnosed, we followed the markers to find their blood samples and complete the tests. Participants were divided into healthy pregnant (HP) and PE groups. Participants were divided into HP and PE groups. Approximately 5 mL of venous blood was collected from each participant at 24-28 weeks gestation. Serum sFlt-1 was measured by enzyme-linked immunosorbent assay. Additionally, D-dimer, activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT), antithrombin III (ATIII), fibrinogen, PLT, PLT distribution width (PDW), and mean PLT volume (MPV) were recorded. SPSS 27.0 software was used to analyze the correlation of these parameters with PE. Receiver operating characteristic curve analysis determined the optimal cutoff value for each parameter.
RESULTS
Serum sFlt-1, APTT, TT, ATIII, PLT, MPV, and PDW levels were significantly different between the PE and HP groups (P < 0.05). Among single-factor indicators for predicting PE, sFlt-1 exhibited the highest value. With an optimal cutoff value of 4.409 ng/mL, sFlt-1 demonstrated a sensitivity and specificity of 85.4% and 87.5%, respectively. The combination of sFlt-1, APTT, TT, PDW, and MPV yielded the highest predictive value, with an area under the receiver operating characteristic curve of 0.946, sensitivity of 86.8%, and specificity of 87.5%.
CONCLUSIONS
This study demonstrates that a combination of sFlt-1, APTT, TT, PDW, and MPV is a valuable tool for predicting PE.
目的
探讨可溶性FMS样酪氨酸激酶-1（sFlt-1）、凝血功能及血小板（PLT）参数对子痫前期（PE）的预测价值。
方法
对2020年10月至2021年12月在上海第五人民医院登记分娩的女性进行前瞻性研究。所有符合条件的孕妇在孕早期初次登记时被纳入研究。然后在孕24 - 28周时统一采集血清样本，将这些样本储存在-80°C的冰箱中并进行标记以建立生物样本库。之后，当诊断出PE时，追踪这些标志物以找到她们的血样并完成检测。参与者被分为健康妊娠（HP）组和PE组。在妊娠24 - 28周时从每位参与者采集约5 mL静脉血。采用酶联免疫吸附测定法检测血清sFlt-1。此外，记录D-二聚体、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、凝血酶原时间（PT）、抗凝血酶III（ATIII）、纤维蛋白原、PLT、血小板分布宽度（PDW）和平均血小板体积（MPV）。使用SPSS 27.0软件分析这些参数与PE的相关性。通过受试者工作特征曲线分析确定每个参数的最佳截断值。
结果
PE组和HP组之间血清sFlt-1、APTT、TT、ATIII、PLT、MPV和PDW水平存在显著差异（P < 0.05）。在预测PE的单因素指标中，sFlt-1的值最高。sFlt-1的最佳截断值为4.409 ng/mL，其敏感性和特异性分别为85.4%和87.5%。sFlt-1、APTT、TT、PDW和MPV的组合具有最高的预测价值，受试者工作特征曲线下面积为0.946，敏感性为86.8%，特异性为87.5%。
结论
本研究表明，sFlt-１、APTT、TT、PDW和MPV的组合是预测PE的有价值工具。
Zotero 插件