标题：重度子痫前期患者血清 sFlt-1、PLGF水平与妊娠结局的相关性

      作者：李岩，鲁翠萍，彭菊兰，陆丽，罗丽琼    深圳市龙华区人民医院产科，广东 深圳 518109

      卷次： 2021年32卷16期

      【摘要】 目的 分析重度子痫前期患者血清中可溶性血管内皮生长因子受体-1 (sFlt-1)和胎盘生长因子(PLGF)水平的变化及其与妊娠结局的相关性。方法 回顾性分析2018年3月至2019年3月深圳市龙华区人民医院产科收治的90例子痫前期患者(观察组)的临床资料，其中轻度子痫前期组50例，重度子痫前期组40例，并选择同期在上述医院体检的45例健康孕妇作为对照组，比较各组孕妇的血清sFlt-1、PLGF水平及妊娠结局，采用Pearson相关分析法分析血清 sFlt-1、PLGF与妊娠结局的相关性。结果 观察组孕妇的血清 sFlt-1F、PLGF水平分别为(4 518.25±100.21) pg/mL、(158.05±15.94) pg/mL，对照组孕妇分别为(2 710.41±112.19) pg/mL、(317.96±20.10) pg/mL，观察组患者的血清 sFlt-1水平明显高于对照组，而PLGF水平明显低于对照组，差异均有统计学意义(P<0.05)；重度子痫前期组患者的血清 sFlt-1F、PLGF水平分别为(5 700.38±255.40) pg/mL、(114.69±15.16) pg/mL，轻度子痫前期组患者分别为(4 214.91±230.82) pg/mL、(155.30±18.03) pg/mL，重度子痫前期组患者血清 sFlt-1F水平明显高于轻度子痫前期组，PLGF水平明显低于轻度子痫前期组，差异均有统计学意义(P<0.05)；重度子痫前期组患者妊娠结局中胎儿宫内窘迫7例(17.50%)、胎儿生长受限8例(20.00%)、胎儿早产5例(12.50%)、新生儿窒息9例(22.50%)，轻度子痫前期组患者妊娠结局中胎儿宫内窘迫 2例(4.00%)、胎儿生长受限 3例(6.00%)、胎儿早产 1例(2.00%)、新生儿窒息 3例(6.00%)，两组子痫前期患者妊娠结局随着疾病严重程度的加重，胎儿宫内窘迫、胎儿生长受限、胎儿早产、新生儿窒息逐渐升高，差异均有统计学意义(P<0.05)；经Pearson相关分析结果显示，血清 sFlt-1水平与胎儿宫内窘迫、胎儿生长受限、胎儿早产、新生儿窒息呈正相关(r值=0.392、0.447、0.494、0.550，P<0.05)，血清PLGF水平与胎儿宫内窘迫、胎儿生长受限、胎儿早产、新生儿窒息呈负相关(r=-0.515、-0.403、-0.447、-0.602，P<0.05)。结论 血清 sFlt-1在重度子痫前期患者中表达明显升高，通过对胎盘血管造成损伤抑制血清PLGF水平的表达，直接影响患者的妊娠结局。
      【关键词】 重度子痫前期；可溶性血管内皮生长因子受体-1；胎盘生长因子；新生儿窒息；相关性；妊娠结局
      【中图分类号】 R714.24+5 【文献标识码】 A 【文章编号】 1003—6350（2021）16—2091—03

Relationship between serum sFlt-1, PLGF levels and pregnancy outcome in patients with severe preeclampsia.
LIYan, LU Cui-ping, PENG Ju-lan, LU Li, LUO Li-qiong. Department of Obstetrics, Shenzhen Longhua District People'sHospital, Shenzhen 518109, Guangdong, CHINA
【Abstract】 Objective To analyze the changes of serum soluble vascular endothelial growth factor receptor-1(sFlt-1) and placental growth factor (PLGF) levels in patients with severe preeclampsia and their correlation with pregnan-cy outcome. Methods The clinical data of 90 patients with preeclampsia (observation group) admitted to Department ofObstetrics, Shenzhen Longhua District People's Hospital from March 2018 to March 2019 were retrospectively analyzed,including 50 patients with mild preeclampsia and 40 patients with severe preeclampsia, and 45 healthy pregnant womenwere selected as the control group. Pearson correlation analysis was used to analyze the correlation between serum sFlt-1,PLGF and pregnancy outcome. Results The serum sFlt-1 and PLGF levels of pregnant women in the observation groupwere (4 518.25±100.21) pg/mL and (158.05±15.94) pg/mL versus (2 710.41±112.19) pg/mL and (317.96±20.10) pg/mLof the pregnant women in the control group (P<0.05); the serum sFlt-1 and PLGF levels of patients in the severe pre-eclampsia group were (5 700.38 ± 255.40) pg/mL and (114.69 ± 15.16) pg/mL versus (4 214.91 ± 230.82) pg/mL and(155.30 ± 18.03) pg/mL of patients in the mild preeclampsia group (P<0.05); in the pregnancy outcome of severe pre-eclampsia, there were 7 cases of fetal distress (17.50%), 8 cases of fetal growth restriction (20.00%), 5 cases of fetal prema-ture delivery (12.50%), 9 cases of neonatal asphyxia (22.50%); in the mild preeclampsia group, there were 2 cases of fetaldistress (4.00%), 3 cases of fetal growth restriction (6.00%), 1 case of premature birth (2.00%), and 3 cases of neonatal as-phyxia (6.00%). The pregnancy outcome of preeclampsia patients in the group increased with the severity of the disease, fe-tal distress, fetal growth restriction, fetal premature delivery, and neonatal asphyxia gradually increased, and the differenceswere statistically significant (all P<0.05); the results of Pearson correlation analysis showed that serum sFlt-1 levels werepositively correlated with fetal distress, fetal growth restriction, fetal premature delivery, and neonatal asphyxia (r=0.392,0.447, 0.494, 0.550, P<0.05), and serum PLGF level was negatively correlated with fetal distress, fetal growth restriction,fetal premature delivery, and neonatal asphyxia (r=-0.515, 0.403, -0.447, -0.602, P<0.05). Conclusion The expressionof serum sFlt-1 is significantly increased in pregnant women with severe preeclampsia, which causes damage to the placen-tal