BACKGROUND & AIMS:
:The purpose of this study was to determine whether increased serum soluble fms-like tyrosine kinase-1 (sFlt-1) and decreased placental growth factor (PlGF) levels in pre-eclampsia are related to the clinical features and laboratory parameters of the patients, including markers of inflammation, endothelial activation and injury, oxidative stress and trophoblast debris. A total of 54 pre-eclamptic patients, 58 healthy pregnant and 52 healthy non-pregnant women were involved in this case-control study. Serum sFlt-1 and PlGF levels were measured by electrochemiluminescence immunoassay. Serum levels of sFlt-1 and PlGF were significantly higher in pre-eclamptic patients and healthy pregnant women than in healthy non-pregnant women. In addition, pre-eclamptic patients had significantly higher sFlt-1 levels and significantly lower PlGF concentrations compared with healthy pregnant women. According to the subgroup analyses, sFlt-1 levels were significantly higher in severely pre-eclamptic patients than in those with mild pre-eclampsia, whereas pre-eclamptic patients with fetal growth restriction or preterm onset of the disease had significantly lower PlGF concentrations compared with those without intrauterine growth restriction or with a disease onset at term. In the pre-eclamptic group, there were significant positive correlations between serum sFlt-1 levels and systolic and diastolic blood pressure, serum levels of blood urea nitrogen and creatinine, as well as plasma levels of von Willebrand factor antigen, fibronectin and cell-free fetal DNA. Furthermore, serum PlGF concentrations of pre-eclamptic patients showed significant positive correlations with gestational age at disease onset and delivery, as well as with fetal birth weight, and significant inverse correlations with levels of blood urea nitrogen, creatinine and fibronectin. In conclusion, increased serum sFlt-1 and decreased PlGF levels are associated with blood pressure, renal and endothelial dysfunction, trophoblast deportation, as well as with a shorter duration of pregnancy, fetal growth restriction, the severity and preterm onset of the disease in pre-eclampsia. These findings indicate the central role of an angiogenic imbalance in the pathogenesis of this pregnancy-specific disorder.
背景与目标:
:本研究的目的是确定先兆子痫患者血清可溶性fms样酪氨酸激酶1(sFlt-1)升高和胎盘生长因子(PlGF)降低是否与患者的临床特征和实验室参数有关包括炎症,内皮细胞活化和损伤,氧化应激和滋养细胞碎片的标志物。该病例对照研究共涉及54名先兆子痫患者,58名健康孕妇和52名健康非孕妇。通过电化学发光免疫测定法测量血清sFlt-1和PlGF水平。子痫前期患者和健康孕妇的血清sFlt-1和PlGF水平显着高于健康非孕妇。此外,与健康孕妇相比,先兆子痫患者的sFlt-1水平明显升高,而PlGF浓度则明显降低。根据亚组分析,严重先兆子痫患者的sFlt-1水平显着高于轻度先兆子痫的患者,而有胎儿生长受限或疾病早发的先兆子痫患者的PlGF浓度则明显低于轻度先兆子痫的患者。没有子宫内生长受限或足月病发作的人。在子痫前期组中,血清sFlt-1水平与收缩压和舒张压,血清尿素氮和肌酐水平以及血浆von Willebrand因子抗原,纤连蛋白和无细胞血浆水平之间存在显着正相关。胎儿DNA。此外,先兆子痫患者的血清PlGF浓度与疾病发作和分娩时的胎龄以及胎儿出生体重呈显着正相关,与血尿素氮,肌酐和纤连蛋白的水平呈显着负相关。总之,血清sFlt-1升高和PlGF水平降低与血压,肾脏和内皮功能障碍,滋养细胞驱逐出境以及妊娠持续时间短,胎儿生长受限,疾病的严重性和早发有关-子痫。这些发现表明在这种妊娠特异性疾病的发病机理中血管生成失衡的核心作用。