[1]徐晓锋,郭历琛,徐 玲,等.孕妇血清PLGF,sFlt-1,Ca2+,25-(OH)-D水平检测及其他危险因素分析对预测子痫前期的临床意义[J].现代检验医学杂志,2019,34(05):35-39.[doi:10.3969/j.issn.1671-7414.2019.05.010]
　XU Xiao-feng,GUO Li-chen,XU Ling,et al.Clinical Significance of Serum PLGF,sFlt-1,Ca2+,25-(OH)-D Levels and Other Risk Factors in Pregnant Women in Predicting Preeclampsia[J].Journal of Modern Laboratory Medicine,2019,34(05):35-39.[doi:10.3969/j.issn.1671-7414.2019.05.010]
点击复制

孕妇血清PLGF,sFlt-1,Ca2+,25-(OH)-D水平检测及其他危险因素分析对预测子痫前期的临床意义()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年05期
页码:
35-39
栏目:
论著
出版日期:
2019-10-29

文章信息/Info

Title:
Clinical Significance of Serum PLGF,sFlt-1,Ca2+,25-(OH)-D Levels and Other Risk Factors in Pregnant Women in Predicting Preeclampsia
文章编号:
1671-7414(2019)05-035-05
作者:
徐晓锋; 郭历琛; 徐 玲; 张 锐; 咸睿星; 石 琴
(上海健康医学院附属嘉定区中心医院妇产科,上海 201800)
Author(s):
XU Xiao-feng; GUO Li-chen; XU Ling; ZHANG Rui; XIAN Rui-xing; SHI Qin
(Department of Obstetrics and Gynecology,Central Hospital of Jiading District, Shanghai Health Medical College,Shanghai 201800,China)
关键词:
血管胎盘内皮生长因子;  可溶性血管内皮生长因子受体-1;  血清钙离子;  25-羟基维生素D;  子痫前期;  危险因素
分类号:
R714.245; R392.11
DOI:
10.3969/j.issn.1671-7414.2019.05.010
文献标志码:
A
摘要:
目的 探讨孕妇血清血管胎盘内皮生长因子(PLGF)、可溶性血管内皮生长因子受体-1(sFlt-1)、钙离子(Ca2+)、25-羟基维生素D[25-(OH)-D]水平及其他危险因素分析对预测子痫前期(PE)的临床意义,为子痫前期的预测提供参考。方法 研究对象为2017年1月～2019年3月期间建卡并生产的164例孕妇,子痫前期组和对照组各82例。收集患者一般资料,测定血清PLGF,sFlt-1,Ca2+和25-(OH)-D水平; 单因素及多因素logistic回归分析确定子痫前期发生的独立危险因素; ROC曲线评估各生化指标的诊断效能。结果 PE组孕妇血清PLGF,Ca2+和25-(OH)-D水平分别为30.52±5.68 pg/ml,1.56±0.16 mmol/L和40.21±6.12 nmol/L,低于对照组(52.88±9.85 pg/ml,2.35±0.25 mmol/L,51.23±9.52 nmol/L),sFlt-1水平(1 457.21±258.63 pg/ml)显著高于对照组(655.45±100.23 pg/ml),差异均有统计学意义(t=1.89～3.24,均P<0.05)。Logistic回归分析表明,患者年龄≥35岁、多胎妊娠、具有高血压家族史、妊娠期高血压、妊娠期尿路感染、不良情绪、血清PLGF降低、sFlt-1升高、Ca2+降低以及25-(OH)-D降低为发生子痫前期的危险因素(OR=2.433～4.669,均P<0.05)。血清PLGF,sFlt-1,Ca2+以及25(OH)-D的ROC曲线下面积分别为0.812,0.583,0.637和0.720; 敏感度分别为87.45%,78.92%,80.66%和83.24%; 特异度分别为80.23%,70.87%,75.14%和76.86%; 联合检测的ROC曲线下面积为0.883,联合检测的敏感度为93.23%,特异度为95.64%,均高于单独检验。结论 子痫前期发生的危险因素具有多元性,分析高危因素同时测定孕妇PLGF,sFlt-1,Ca2+以及25-(OH)-D可用于预测PE的发生。
Abstract:
Objective To explore the clinical significanceof serum PLGF,sFlt-1,Ca2+,25-(OH)-D levels and other risk factors in pregnant women in predicting preeclampsia and provide reference for the prediction of preeclampsia(PE).Methods The subjects were 164 pregnant women in obstetrics department of Central Hospital of Jiading District from January 2017 to March 2019,82 in preeclampsia group and 82 in control group.General data of patients were collected and serum levels of PLGF,sFlt-1,Ca2+ and 25-(OH)-D were measured.Univariate and multivariate logistic regression analysis was used to determine independent risk factors for preeclampsia.ROC curve was used to evaluate the diagnostic efficacy of biochemical indicators.Results The serum levels of PLGF,Ca2+ and 25-(OH)-D in PE group were significantly lower than those in control group(30.52±5.68 pg/ml,1.56±0.16 mmol/L and 40.21±6.12 nmol/L,52.88±9.85 pg/ml,2.35±0.25 mmol/L and 51.23±9.52 nmol/L),and sFlt-1(1 457.21±258.63 pg/ml)were significantly higher than those in control group(655.45±100.23pg/ml).Logistic regression analysis showed that age(≥35 year),multiple pregnancy,family history of hypertension,hypertension during pregnancy,urinary tract infection during pregnancy,bad mood,decreased serum PLGF,elevated sFlt-1,decreased serum Ca2+ and 25-(OH)-D were risk factors for preeclampsia(OR=2.433～4.669,all P<0.05).The area under the ROC curve of PLGF,sFlt-1,Ca2+ and 25-(OH)-D was 0.812,0.583,0.637 and 0.720,respectively.The sensitivity was 87.45%,78.92%,80.66% and 83.24%,respectively.The specificity was 80.23%,70.87%,75.14% and 76.86%,respectively.The area under the ROC curve of joint detection was 0.883,and the sensitivity of joint detection was 93.23% and 83.24%,respectively.The specificity was 95.64%,which was higher than that of single test.Conclusion The risk factors of preeclampsia are multivariate.The determination of PLGF,sFlt-1,serum Ca2+ and 25-(OH)-D in pregnant women has certain predictivevalue for preeclampsia.

参考文献/References:

[1] 庄彩霞,刘俊涛,高劲松.中国人群子痫前期发病率和临床危险因素分析[J].生殖医学杂志,2019,28(4):336-341. ZHUANG Caixia,LIU Juntao,GAO Jinsong.Incidence and clinical risk factors of preeclampsia in China[J].Journal of Reproductive Medicine,2019,28(4):336-341. [2] 李可,朱大伟,陈建昆,等.子痫前期发病机制与临床治疗研究进展[J].解放军医学杂志,2019,44(5):423-429. LI Ke,ZHU Dawei,CHEN Jiankun,et al.Progress in the study for pathogenesis and clinical treatment of preeclampsia[J].Med J Chin PLA,2019,44(5):423-429. [3] PRINJA P, NEISON-PIERCY C.Hypertension in pregnancy[J].Medicine,2018,46(12):743-746. [4] PARE E,PARRY S,MCELRATH T F,et al.Clinical risk factors for preeclampsia in the 21st century[J].Obstetrics & Gynecology,2014,124(4):763-770. [5] 傅岚.妊娠子痫前期患者发病的高危影响因素分析[J].当代医学,2016,22(10):53-54. FU Lan.Analysis of high risk factors of preeclampsia[J].Contemporary Medicine,2016,22(10):53-54. [6] 吕艳关,王丽,赵玉杰.子痫前期患者血清PCT,HSP90及hs-CRP检测的临床意义[J]. 现代检验医学杂志,2018,33(4):83-86. L(¨overU)Yanguan,WANG Li,ZHAO Yujie.Clinical significance of detecting serum PTC,HSP90 and hs-CRP in patients with pre-eclamptic[J].Journal of Modern Laboratory Medicine,2018,33(4):83-86. [7] NGUYEN T H,BUI T C,VO T M,et al.Predictive value of the sFlt-1 and PlGF in women at risk for preeclampsia in the south of Vietna[J].Pregnancy Hypertension,2018,14:37-42. [8] ENENGL S,TRAUTNER P,SHEBL O J,et al.The sFlt-1/PlGF ratio and its predictive value concerning time to delivery in patients with preeclampsia-preliminary data[J].Geburtshilfe and Frauenheilkunde,2018,78(5):A21. [9] 熊矿辉,周群艳.血清25-(OH)D_3水平与子痫前期孕妇内皮损伤及胎盘细胞凋亡的关系[J].中国妇幼保健,2019,34(10):2205-2208. XIONG Kuanghui,ZHOU Qunyan.Correlation of serum 25-(OH)_D3 levelswith maternal endothelial injury and placental apoptosis in pregnant women withpreeclampsia[J].Maternal and Child Health Care of China,2019,34(10):2205-2208. [10] 高颖,林胜兰.血清钙离子、D-二聚体和25-羟基维生素D与妊娠期高血压疾病的相关性分析[J].中国妇幼保健,2018,33(3):533-535. GAO Ying,LIN Shenglan.Analysis of the correlation between serum calciumion, D-dimer and 25-hydroxyvitamin D and hypertensive disorders in pregnancy[J].Maternal and Child Health Care of China,2018,33(3):533-535.

备注/Memo

备注/Memo:
基金项目:上海市嘉定区危重孕产妇抢救中心支持项目(编号:JDYXZDZK-6)。 作者简介:徐晓锋(1984-),男,硕士,主治医师,研究方向:妇科肿瘤微创治疗,E-mail:xiaoxfeng999@sina.com。 通讯作者:石 琴,副主任医师,E-mail:shiqin0901@126.com
更新日期/Last Update: 2019-10-20