Objective To investigate the serum changes of pregnancy-associated plasma protein-A (PAPP-A), vascular endothelial growth factor (VEGF) in patients with preeclampsia, and to analyze their correlation with the severi-ty of disease. Methods From January 2013 to December 2014, 90 pregnant women who had prenatal examinations and delivered in the Department of Obstetrics, Shanghai Pudong Hospital were recruited, including 60 patients with pre-eclampsia (PE group) and 30 healthy pregnant women (control group). The 60 patients with PE were divided into severe PE group (n=30) and mild PE group (n=30) according to the severity of the disease. Enzyme-linked immunosorbent as-say (ELISA) was used to determine the serum concentrations of PAPPA-A and VEGF. The correlations between the ex-pression of serum PAPPA-A, VEGF and the severity of the disease were analyzed. Results The newborn birth weight of the severe PE group [(3.4 ± 0.5) kg] were less than that of the mild PE group [(3.6 ± 1.4) kg] and control group [(3.7 ± 0.5) kg], and the differences were statistically significant (P<0.05). The serum levels of PAPPA-A, VEGF and 24 hours urinary protein in the severe PE group [(900.6±379.0)μg/ml, (7.2±4.2) pg/ml, (2.5±1.2) g/24 h] and the mild PE group [(783.8 ± 204.7) μg/ml, (5.3 ± 1.4) pg/ml, (1.4 ± 0.3) g/24 h] were significantly higher than those in the control group [(592.9±222.9)μg/ml, (4.8±2.8) pg/ml, (0.2±0.1) g/24 h], P<0.05. The serum level of PAPPA-A and the 24 hours urinary protein in the severe PE group were higher than those in the mild PE group (P<0.05). Spearman's correlation analysis showed that the serum level of PAPPA-A was positively correlated with the serum concentration of VEGF (P<0.05). Conclusion PAPPA and VEGF are involved in the occurrence and development of preeclampsia.%目的 观察子痫前期患者血清中妊娠相关血浆蛋白A (PAPP-A)及血清血管内皮生长因子(VEGF)表达情况,探讨其与子痫前期病情严重程度的关系.方法 选择2013年1月至2014年12月在上海市浦东医院门诊行常规产前检查并分娩的子痫前期孕妇60例为子痫前期组,根据病情严重程度将其分为轻度子痫前期组30例,重度子痫前期组30例.选取同期行本院门诊产前检查并住院分娩的正常孕妇30例为对照组.分别采用酶联免疫吸附试验测定三组孕妇血清中的PAPP-A水平和VEGF的水平,分析其与子痫前期患者病情严重程度的关系.结果 重度子痫前期组新生儿出生体重[(3.4±0.5) kg]低于轻度子痫前期组[(3.6±1.4) kg]和对照组[(3.7±0.5) kg],差异均具有统计学意义(P<0.05);重度子痫前期组患者血清PAPP-A值、VEGF值和24 h尿蛋白值分别为(900.6 ± 379.0) μg/ml、(7.2±4.2) pg/ml、(2.5±1.2) g/24 h,轻度子痫前期组分别为(783.8±204.7) μg/ml、(5.3±1.4) pg/ml、(1.4±0.3) g/24 h,均分别高于对照组的(592.9±222.9) μg/ml、(4.8±2.8) pg/ml、(0.2±0.1) g/24 h,差异均具有统计学意义(P<0.05);重度子痫前期组的血清PAPP-A值和24 h尿蛋白值均高于轻度子痫组,差异具有统计学意义(P<0.05);Speraman相关分析显示,血清PAPP-A值和血清VEGF值呈明显的正相关(r=0.574,P<0.05).结论 PAPPA及VEGF均参与了子痫前期的发生及发展.
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