子痫前期患者血清APN和sFlt-1水平与子宫螺旋动脉血流变化关系

摘要

目的：探讨子痫前期患者血清脂联素（ APN）水平和可溶性血管内皮生长因子受体1（ sFlt-1）水平与子宫螺旋动脉血流变化的关系。方法选择于象山县红十字台胞医院门诊进行孕期检查并住院分娩的60例子痫前期患者作为研究组，另选取同期进行孕期检查并住院分娩的60例健康孕妇作为对照组。检测产妇血清ANP水平及sFlt-1水平，并采用多普勒彩色超声检测其子宫螺旋动脉搏动指数（ PI）、收缩末期最大血流速度（ S）与舒张末期最大血流速度（ D）比值。结果研究组患者血清ANP和sFlt-1水平均较健康对照组明显增加（t值分别为8．83、14．2，均P＜0．05）；而重度子痫前期组血清ANP和sFlt-1水平均明显高于轻度子痫前期组和健康对照组（t值分别为7．10、10．03、9．22、15．30，均P＜0．05）。研究组患者子宫螺旋动脉PI值和S／D比值均较健康对照组明显增加（t值分别为7．23、8．82，均P＜0．05）；而重度子痫前期组子宫螺旋动脉PI值和S／D比值均明显高于轻度子痫前期组和健康对照组（t值分别为6．73、8．48、7．22、9．39，均P＜0．05）。子痫前期患者血清ANP水平与子宫螺旋动脉PI值（r＝0．322，P＜0．05）和S／D比值（r＝0．406，P＜0．05）均呈正相关趋势；血清sFlt-1水平与子宫螺旋动脉PI值（r＝0．388，P＜0．05）和S／D比值（ r＝0．465，P＜0．05）均呈正相关趋势。结论血清ANP和sFlt-1水平及子宫螺旋动脉的生理性改变与妊娠期高血压的发生和发展有一定相关性，并参与子痫前期的病理过程，可将其作为子痫前期的预测指标。%Objective To investigate the correlation between serum levels of adiponectin ( APN) and soluble vascular endothelial growth factor receptor 1 ( sFlt-1 ) and changes of uterine spiral artery blood flow in patients with preeclampsia .Methods Sixty preeclampsia patients taking prenatal examination and delivering in Red Cross Taibao Hospital of Xiangshan County were selected in study group , and 60 cases of normal pregnant women were selected at the same period in control group .The levels of serum APN and sFlt-1 were detected , and the uterine spiral artery pulsatility index (PI), end systolic peak flow velocity (S) and end diastolic peak flow velocity (D) ratio were detected by color Doppler ultrasound .Results APN and sFlt-1 levels in the study group were significantly higher compared with the control group (t value was 8.83 and 14.2, respectively, both P<0.05), and those in severe preeclampsia group were significantly higher than those in mild preeclampsia group and the control group (t value was 7.10, 10.03, 9.22 and 15.30, respectively, all P<0.05).Uterine spiral artery PI and the ratio of S/D of patients in the study group increased significantly compared with the control group (t value was 7.23 and 8.82, respectively, both P<0.05), and those in severe preeclampsia group were significantly higher than those in mild preeclampsia group and the control group (t value was 6.73, 8.48, 7.22 and 9.39, respectively, all P<0.05).The serum APN level was positively correlated with uterine spiral artery PI values and the ratio of S/D in patients with preeclampsia ( r value was 0.322 and 0.406, respectively, both P<0.05), and sFlt-1 level in serum was also positively correlated with uterine spiral artery PI values and the ratio of S /D (r value was 0.388 and 0.465, respectively, both P<0.05).Conclusion The levels of serum APN and sFlt-1 and physiological changes of uterine spiral arteries are related with the occurrence and development of gestational hypertension , and they involve in the pathological processes of preeclampsia .In clinics they can be used as predictors of preeclampsia .