摘要
目的探讨子痫前期患者血清胰岛素样生长因子-1(IGF-1)、胎盘生长因子(PLGF)、可溶性血管内皮生长因子受体-1(sFlt-1)、可溶性CD40L配体(sCD40L)水平与围生结局的关系。方法选择2020年9月至2022年2月陕西中医药大学第二附属医院收治的96例子痫前期患者作为观察组,并选择同期我院产检的健康孕妇96例作为对照组。比较观察组和对照组、观察组不同病情程度患者的血清IGF-1、PLGF、sFlt-1、sCD40L水平,并比较观察组和对照组的不良围生结局发生率以及观察组不同围生结局患者的血清IGF-1、PLGF、sFlt-1、sCD40L水平,采用Pearson相关性分析法分析血清IGF-1、PLGF、sFlt-1、sCD40L水平和不良围生结局的相关性。结果观察组患者的血清IGF-1、PLGF水平分别为(80.03±16.72)μg/L、(137.25±26.80)pg/mL,明显低于对照组的(222.01±32.64)μg/L、(312.57±41.23)pg/mL,sFlt-1、sCD40L水平分别为(1451.83±205.27)ng/L、(8.11±1.64)ng/L,明显高于对照组的(309.83±51.71)ng/L、(2.87±0.49)ng/L,差异均有统计学意义(P<0.05);观察组中病情重度组患者的血清IGF-1、PLGF水平分别为(68.92±7.68)μg/L、(101.52±16.32)pg/mL,明显低于轻度组的(102.83±11.57)μg/L、(158.27±21.60)pg/mL,sFlt-1、sCD40L水平分别为(1178.54±158.91)ng/L、(6.40±1.21)ng/L,明显高于轻度组的(1670.32±173.66)ng/L、(9.97±1.59)ng/L,差异均有统计学意义(P<0.05);观察组患者的不良围生结局总发生率为23.96%,明显高于对照组的4.17%,差异有统计学意义(P<0.05);观察组中结局不良组患者的血清IGF-1、PLGF水平分别为(65.12±7.59)μg/L、(104.29±18.73)pg/mL,明显低于结局良好组的(98.80±13.26)μg/L、(155.61±21.49)pg/mL,sFlt-1、sCD40L水平分别为(1038.67±171.40)ng/L、(6.19±1.52)ng/L,明显高于结局良好组的(1693.82±213.25)ng/L、(10.01±1.71)ng/L,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,血清IGF-1、PLGF和不良围生结局之间呈负相关(r=-0.527、-0.585,P<0.05),血清sFlt-1、sCD40L和不良围生结局之间呈正相关(r=0.493、0.526,P<0.05)。结论子痫前期患者血清IGF-1、PLGF水平明显降低,血清sFlt-1、sCD40L水平明显升高,且和不良围生结局具有明显相关性。
Objective To study the relationship between serum insulin-like growth factor-1(IGF-1),placental growth factor(PLGF),soluble vascular endothelial growth factor receptor-1(sFlt-1),soluble CD40L ligand(sCD40L)levels and perinatal outcomes in patients with preeclampsia.Methods A total of 96 patients with preeclampsia admitted to the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from September 2020 to February 2022 were selected as the observation group,and 96 healthy pregnant women who underwent prenatal examination in the hospital during the same period were selected as the control group.The serum IGF-1,PLGF,sFlt-1 and sCD40L levels were compared between the observation group and the control group,and between the observation group with different degrees of illness.The incidence of adverse perinatal outcomes in the observation group and the control group,and the serum IGF-1,PLGF,sFlt-1 and sCD40L levels in the observation group with different perinatal outcomes were compared.Pearson correlation analysis was used to analyze the correlation between the serum IGF-1,PLGF,sFlt-1,sCD40L levels and adverse perinatal outcomes.Results The serum IGF-1,PLGF levels in the observation group were(80.03±16.72)μg/L and(137.25±26.80)pg/mL,which were significantly lower than(222.01±32.64)μg/L and(312.57±41.23)pg/mL in the control group,and the sFlt-1 and sCD40L levels were(1451.83±205.27)ng/L and(8.11±1.64)ng/L,significantly higher than(309.83±51.71)ng/L and(2.87±0.49)ng/L in the control group(P<0.05).The serum IGF-1,PLGF levels in the severe group of the observation group were(68.92±7.68)μg/L and(101.52±16.32)pg/mL,which were significantly lower than(102.83±11.57)μg/L and(158.27±21.60)pg/mL in the mild group,while the sFlt-1 and sCD40L levels were(1178.54±158.91)ng/L and(6.40±1.21)ng/L,significantly higher than(1670.32±173.66)ng/L and(9.97±1.59)ng/L in the mild group(P<0.05).The total incidence of adverse perinatal outcomes in the observation group was 23.96%,which was significantly higher than 4.17%in the control group(P<0.05).The IGF-1 and PLGF levels in the poor outcome group of the observation group were(65.12±7.59)μg/L and(104.29±18.73)pg/mL,which were significantly lower than(98.80±13.26)μg/L and(155.61±21.49)pg/mL in the good outcome group,while the sFlt-1 and sCD40L levels were(1038.67±171.40)ng/L and(6.19±1.52)ng/L,significantly higher than(1693.82±213.25)ng/L and(10.01±1.71)ng/L in the good outcome group,(P<0.05).Pearson correlation analysis results showed that serum IGF-1 and PLGF were negatively correlated with adverse perinatal outcomes(r=-0.527,-0.585,P<0.05),while serum sFlt-1 and sCD40L were positively correlated with adverse perinatal outcomes(r=0.493,0.526,P<0.05).Conclusion The levels of serum IGF-1 and PLGF in patients with preeclampsia were significantly decreased,and the levels of serum sFlt-1 and sCD40L were significantly increased,which were significantly correlated with adverse perinatal outcomes.
作者
连李斌
陈蓓
段蓓
LIAN Li-bin;CHEN Bei;DUAN Bei(Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2023年第7期983-986,共4页
Hainan Medical Journal
基金
陕西省卫生健康科研基金项目(编号:2018D085)。
