血清可溶性FMS样酪氨酸激酶/胎盘生长因子比值预测早发型子痫前期的临床意义
| 作者: |
1胡吉霞,
1肖丽,
1汪文雁
1 中国人民解放军陆军第七十三集团军医院产科，福建 厦门 361001 |
| 通讯: |
汪文雁
Email: wenyanwang123@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2022.03.015 |
摘要
目的：探究孕早期血清可溶性FMS样酪氨酸激酶(soluble FMS-like tyrosine kinase-1，sFIt-1)/胎盘生长因子(placenta growth factor，PIGF)比值预测早发型子痫前期(early-onset preeclampsia，EOPE)的临床意义。方法：选取2018年10月至2020年11月在中国人民解放军陆军第七十三集团军医院进行早期产检并分娩的50例EOPE孕妇为研究组，同期选择与研究组孕妇年龄、孕周匹配的正常健康孕妇60例为对照组。比较两组孕早期血清sFIt-1、PIGF水平及sFIt-1/PIGF比值，并分析与孕中期24 h尿蛋白、血压的相关性。应用受试者工作特征(receiver operating characteristic，ROC)曲线评价相关指标对EOPE及不良妊娠结局的预测价值。结果：研究组血清sFIt-1水平、sFIt-1/PIGF比值高于对照组(P<0.05)，PIGF水平低于对照组(P<0.05)；Pearson相关性分析结果显示孕早期血清sFIt-1水平、sFIt-1/PIGF比值与孕中期24 h尿蛋白、收缩压、舒张压均呈正相关(P<0.05)，而孕早期PIGF与孕中期24 h尿蛋白、收缩压、舒张压均呈负相关(P<0.05)；ROC曲线分析显示sFIt-1、PIGF水平及sFIt-1/PIGF比值预测EOPE的曲线下面积(area under the curve，AUC)分别为0.858(95%CI：0.779~0.917)、0.818(95%CI：0.733~0.885)、0.873(95%CI：0.796~0.929)，以sFIt-1/PIGF比值的AUC最大，其特异度和敏感度分别为98.30%、84.00%；sFIt-1、PIGF水平及sFIt-1/PIGF比值预测不良妊娠结局发生的AUC分别为0.768(95%CI：0.628~0.876)、0.809(95%CI：0.673~0.906)、0.936(95%CI：0.829~0.985)，其中sFIt-1/PIGF比值的AUC最大，特异度和敏感度分别为97.06%、97.75%。结论：孕早期sFIt-1/PIGF比值对EOPE及不良妊娠结局进行预测，具有较高的特异度和敏感度。
关键词：
可溶性FMS样酪氨酸激酶；胎盘生长因子；早发型子痫前期；预测
Clinical significance of ratio of soluble FMS-like tyrosine kinase-1 and placenta growth factor to predict early onset preeclampsia
CorrespondingAuthor: WANG Wenyan Email: wenyanwang123@163.com
DOI: 10.3978/j.issn.2095-6959.2022.03.015
Abstract
Objective: To explore the clinical significance of ratio of soluble FMS-like tyrosine kinase-1 (sFIt-1) and placenta growth factor (PIGF) in early pregnancy to predict early-onset preeclampsia (EOPE). Methods: Fifty pregnant women with EOPE were selected from October 2018 to November 2020 as a study group, and 60 healthy pregnant women matched with the age and gestational age of the study group were selected as a control group. The levels of serum sFIt-1, PIGF and sFIt-1/PIGF radio in early pregnancy were compared between the 2 groups, and the correlation with 24 h urine protein and blood pressure in the second trimester pregnancy was analyzed. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of related indicators for EOPE and adverse pregnancy outcomes. Results: The level of serum sFIt-1 and sFIt-1/PIGF ratio in the study group were higher than that in the control group (P<0.05), and the level of PIGF in the study group were lower than that in the control group (P<0.05). Pearson correlation analysis showed that serum sFIt-1 level and sFIt-1/PIGF ratio in early pregnancy were positively correlated with 24 h urinary protein, systolic blood pressure and diastolic blood pressure in second trimester (P<0.05), while PIGF in early pregnancy was negatively correlated with 24 h urinary protein, systolic blood pressure and diastolic blood pressure in second trimester (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of sFIt-1, PIGF and sFIt-1/PIGF ratio for predicting were 0.858 (95%CI: 0.779 to 0.917), 0.818 (95%CI: 0.733 to 0.885), and 0.873 (95%CI: 0.796 to 0.929), respectively. The AUC of sFIt-1/PIGF ratio was the largest, with the specificity and sensitivity of 98.30% and 84.00%, respectively. The AUC of sFIt-1, PIGF and sFIt-1/PIGF ratio in predicting EOPE adverse pregnancy outcomes were 0.768 (95%CI: 0.628 to 0.876), 0.809 (95%CI: 0.673 to 0.906) and 0.936 (95%CI: 0.829 to 0.985), respectively. The AUC of sFIt-1/PIGF ratio was the largest, and the specificity and sensitivity were 97.06% and 97.75%, respectively. Conclusion: sFIt-1/PIGF ratio in early pregnancy has high specificity and sensitivity in predicting EOPE and adverse pregnancy outcomes.
Keywords：
soluble FMS-like tyrosine kinase-1; placental growth factor; early-onset preeclampsia; predict