国际妇产科学杂志

国际妇产科学杂志 ›› 2016, Vol. 43 ›› Issue (3): 308-311.

• 论著 • 上一篇    下一篇

外周血sFlt-1、PlGF、25-羟基维生素D、D-二聚体、vWF及P-选择素等指标预测子痫前期的价值

何雪仪，王晨虹   

  1. 518028 广东省深圳市，南方医科大学附属深圳妇幼保健院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2016-06-22 发布日期:2016-06-22

Clinical Value of Soluble Fms-like Tyrosine Kinase-1，Placental Growth Factor，25-hydroxyvitamin D，D-dimer，von Willebrand Factor，P-selectin for the Risk Assessment of Preeclampsia during the First Trimester of Pregnancy

HE Xue-yi，WANG Chen-hong   

  1. Shenzhen Maternity and Child Healthcare Hospital，Southern Medical University，Shenzhen 518028，Guangdong Province, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2016-06-22 Online:2016-06-22

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摘要： 目的：分析可溶性血管内皮生长因子受体-1（sFlt-1）、胎盘生长因子（PlGF）、25-羟基维生素D（25-OH-VD）、D-二聚体、血管性假血友病因子（vWF）及P-选择素在子痫前期患者妊娠早期外周血中的表达，探讨其在子痫前期发生中的预测价值。方法：选择2013年1—12月在南方医科大学附属深圳妇幼保健院产科门诊进行产前检查的1 081例妊娠10～13+6周的单胎孕妇作为研究对象，选取发生子痫前期者为病例组（50例），同期无妊娠并发症以及合并症的正常妊娠妇女352例作为对照组。采用酶联免疫吸附试验（ELISA）检测外周血中sFlt-1、PlGF、25-OH-VD、D-二聚体、vWF及P-选择素的浓度。通过受试者工作特征（ROC）曲线分析这6个生化指标预测PE发生的敏感度和特异度。结果：①病例组外周血sFlt-1、D-二聚体、vWF及P-选择素平均值均高于对照组，差异有统计学意义（P＜0.05）；外周血PlGF及25-OH-VD平均值病例组均低于对照组，差异有统计学意义（P＜0.05）；②ROC曲线结果显示，sFlt-1、PlGF、25-OH-VD、D-二聚体、vWF及P-选择素的中位数倍数（MoM）之和预测子痫前期，具有较高的敏感度（78%）和特异度（100%）。结论：妊娠早期联合检测外周血sFlt-1、PlGF、25-OH-VD、D-二聚体、vWF及P-选择素多项生物学指标联合能提高子痫前期的预测价值。

关键词: 先兆子痫, 血管内皮生长因子受体1, 胎盘生长因子, 骨化二醇, D-二聚体, 血管性假血友病因子, 选择素类, 先兆子痫, 血管内皮生长因子受体1, 胎盘生长因子, 骨化二醇, D-二聚体, 血管性假血友病因子, 选择素类

Abstract: Objective：To evaluate the signification of serum soluble fms-like tyrosine kinase－１（ｓＦｌｔ－１），placental growth factor（ＰlＧＦ），25-hydroxyvitamin D（25-OH-VD），D-dimer，von Willebrand factoｒ（ｖＷＦ），P-selectin for predicting risk of pre-eclampsia（PE） during the first trimester of pregnancy. Methods：In this nested cohort ，we recruited 1 081 consecutive women who presented for antenatal care between 10 and 13+6 weeks of gestation from Shenzhen Maternity and Child Healthcare Hospital from January 2013 to December 2013. Of the 1 081 pregnant women studied，50 patients were diagnosed with PE as case group. There are 352 normal pregnant women without complications as control group. Serum sFlt-1，PLGF，25-OH-VD，D-dimer，vWF and P-selectin were detected by ELISA. Using ROC curve to evaluate the value of diagnosis preeclampsia for the six index alone or combination. Results：During 10-13+6 weeks of gestation serum levels of sFlt-1，D-dimer，vWF，P-selectin of gravida with PE were significantly higher than the control group （P＜0.05）. The serum PlGF and 25-OH-VD levels in case group was significantly lower than that in the control group（P＜0.05）. Combining total multiple of median （MoM） of serum sFlt-1，PlGF，25-OH-VD，D-dimer，vWF，P-selectin using ROC curve analysis can get a sensitivity of 78% and a specificity of 100% for predicting the risk of PE. Conclusions：Combining screening of different biomarkers such as serum sFlt-1，PlGF,25-OH-VD，D-dimer，vWF and P-selectin could increase the predictive value of PE at the first trimester pregnancy.

Key words: Pre-eclampsia, Vascular endothelial growth factor receptor-1, Placental growth factor, Calcifediol, D-dimer, von Willebrand factor, Pre-eclampsia, Vascular endothelial growth factor receptor-1, Placental growth factor, Calcifediol, D-dimer, von Willebrand factor, Selectins