网络首发:2015-12-20,
纸质出版:2015
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PIGF、sVEGFR-1、NO联合PI对高危孕妇发生子痫 前期的预测[J]. 中山大学学报(医学科学版), 2015,36(6).
PIGF, sVEGFR -1, NO, and PI for Prediction of Preeclampsia in High -risk Women[J]. Journal of Sun Yat-sen University (Medical Sciences), 2015, 36(6).
摘 要: 【目的】 探讨血清胎盘生长因子(PIGF)、可溶性血管内皮生长因子受体-1(sVEGFR-1)、一氧化氮(NO)浓度联合子宫动脉搏动指数(PI)在高危孕妇中预测子痫前期发生的价值。【方法】 收集162例具有子痫前期高危因素孕妇妊娠22~26周时的血清标本,应用酶联免疫吸附试验(ELISA)检测PIGF及sVEGFR-1浓度,比色法检测NO浓度,同期行子宫动脉多普勒超声检查测定PI值。【结果】 ①34例孕妇发生子痫前期(子痫前期组),128例孕妇血压始终维持正常(血压正常组)。②子痫前期组孕妇血清中PIGF、sVEGFR-1、NO水平及PI分别为(264 ± 116)pg/mL、(4823 ± 1562)pg/mL、(57 ± 28)μmol/L、2.7 ± 0.1;血压正常组分别为(418 ± 130)pg/mL 、(1102 ± 158)pg/mL 、(107 ± 28)μmol/L 、2.2 ± 0.2。两组比较,差异均有统计学意义(P < 0.001)。③单一参数预测子痫前期的敏感度和特异度PlGF为78.0%和80.7%(切割值为286.3 pg/mL时),sVEGFR-1为81.2%和83.5%(切割值为 2 005.0 pg/mL时),NO为75.2%和80.0%(切割值为50.9 μmol/L时),PI为79.6%和86.2%(切割值为2.31时)。联合4项参数阳性值预测子痫前期的敏感度和特异度为92.7%和95.6%,均高于单一参数(P < 0.001)。血清PIGF、sVEGFR-1、NO的浓度与母亲的妊娠结局显著关联(P < 0.001)。【结论】 血清PIGF、sVEGFR-1、NO浓度联合PI在孕22~26周的高危孕妇中预测子痫前期的发生有较好的临床价值。
Abstract: 【Objective】 This study was to determine the value of the combining of serum placental growth factor (PIGF), soluble vascular endothelial growth factor receptor -1 (sVEGFR -1), nitric oxide (NO) concentrations and uterine arterial pulsatility index(PI)for the prediction of preeclampsia in high -risk pregnant women.【Methods】 Serum samples of 162 pregnant women with high preeclampsia risk were obtained between 22 and 26 weeks of gestation. PIGF and sVEGFR -1 concentrations were measured by enzyme -linked immunosorbent assay (ELISA),NO concentration was measured by colorimetric assay. Uterine artery PI was tested by Doppler ultrasound. 【Results】 ① 34 pregnant women were found to develop preeclampsia later(preeclampsia group), the blood presure of the other 128 women remained normal(normal blood pressure group). ②The mean value of serum PIGF, sVEGFR -1, NO, and PI were (264 ± 116)pg/mL, (4823 ± 1562)pg/mL, (57 ± 28)μmol/L, 2.7 ± 0.1 respectively in the preeclampsia group, and (418 ± 130)pg/mL, (1102 ± 158)pg/mL, (107 ± 28)μmol/L, 2.2 ± 0.2 respectively in the normal blood pressure group. There was significantly different between two groups respectively(P < 0.001). ③The sensitivity and specificity to predict preeclampsia of single parameter were 78.0% and 80.7% for PIGF (cut off value 286.3 pg/mL), 81.2% and 83.5% for sVEGFR -1(cut off value 2 005.0 pg/mL), 75.2% and 80.0% for NO(cut off value 50.9μmol/L),79.6% and 86.2% for PI(cut off value 2.31). The sensitivity and specificity to predict preeclampsia of the combing of four positive value parameters were 92.7% and 95.6% respectively. Both were higher than any single parameter(P < 0.001). The concentrations of serum PIGF, sVEGFR -1, NO were correlated with maternal pregnant outcome significantly(P < 0.001). 【Conclusions】 Serum PIGF, sVEGFR-1, NO and PI in high-risk women with 22 -26 weeks of gestation may have good clinical value for the prediction of preeclampsia.
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