VEGF及其受体SFLT-1水平与重度子痫前期孕妇新生儿结局的关系

摘要

目的 探讨血管内生长因子(VEGF)及可溶性血管内皮生长因子受体-1(SFLT-1)水平与重度子痫前孕妇新生儿结局的关系.方法 选取40例重度子痫前期孕妇患者作为研究组,另选取40例正常孕妇作为对照组,采用酶联免疫吸附试验(ELISA)测量两组孕妇孕晚期(孕35周)和临产前(孕妇生产的孕周,孕36~40周)血清中VEGF及其受体SFLT-1水平,并比较两组孕妇新生儿结局.结果 研究组孕晚期和临产前的VEGF水平分别为(18.58±1.73)ng/L、(20.56±3.78)ng/L,对照组为(31.54±3.16)ng/L、(33.85±3.07)ng/L.差异均有统计学意义(t1=47.1779,t2=21.3956,均P<0.05);研究组孕晚期和临产前的SFLT-1水平水平分别为(36.58±3.68)μg/L、(38.76±2.87)μg/L,对照组为(8.56±1.82)μg/L、(11.25±3.20)μg/L,差异均有统计学意义(t1=47.0032,t2=55.9309,均P<0.05);在新生儿结局比较上,两组胎盘重量、羊水污染、1min Apgar评分及新生儿体重均存在明显差异(t1=5.3824,t2=11.2514,χ23=7.7942,t4=5.5094,均P<0.05).结论 重度子痫前期孕妇患者VEGF及其受体SFLT-1与正常孕妇存在明显差异,高水平SFLT-1会引起内皮细胞激活和损伤,是造成新生儿体重过低、血压升高和蛋白尿的关键因素.%Objective To investigate the relationship between vascular endothelial growth factor (VEGF) and soluble fms-like tyrosine kinase receptor-1 (SFLT-1) level and neonatal outcomes in pregnant women with severe preeclampsia. Methods Forty cases of pregnant women with severe preeclampsia were selected in study group. Another 40 cases of normal pregnant women were selected in control group. Serum VEGF and its receptor SFLT-1 levels in two groups of pregnant women in late pregnancy (35 gestational weeks) and before labor ( gestational week of production, 36 -40 gestational weeks ) were detected with enzyme linked immunosorbent assay ( ELISA ) , and neonatal outcomes between two groups were compared. Results VEGF levels in late pregnancy and before labor of women in study group was 18. 58 ± 1. 73ng/L and 20. 56 ± 3. 78ng/L, respectively, and those in control group was 31. 54 ± 3. 16ng/L and 33. 85 ± 3. 07ng/L, respectively. The differences were statistically significant (t1 =47. 1779, t2 =21. 3956, both P<0. 05). SFLT-1 level in late pregnancy and before labor of women in study group was 36. 58 ± 3. 68ug/L and 38. 76 ± 2. 87ug/L, respectively, and those in control group was 8. 56 ± 1. 82ug/L and 11. 25 ± 3. 20ug/L, respectively. There were significant differences between two groups ( t1 =47. 0032, t2 =55. 9309, both P<0. 05). Comparison of neonatal outcomes between two groups showed that there were significant differences in placental weight, contamination of amniotic fluid, 1min Apgar score and neonatal weight (t1 =5. 3824, t2 =11. 2514,χ23 =7. 7942, t4 =5. 5094, all P<0. 05). Conclusion There are significant differences in VEGF and its receptor SFLT-1 between pregnant women with severe preeclampsia and normal pregnant women. High levels of SFLT-1 will cause endothelial cell activation and injury, which is the key factor for low birth weight, high blood pressure and proteinuria of neonates.