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目的探讨子痫前期(preeclampsia,PE)患者血清可溶性Endoglin(soluble Endoglin,s Eng)及可溶性Fms样酪氨酸激酶-1(soluble Fms-like tyrosine kinase,s Flt-1)水平变化及其临床意义。方法回顾性纳入遂宁市中心医院2009年6月—2014年6月就诊的PE患者96例,根据病情严重程度分为轻度PE组(54例)及重度PE组(42例),同时设置健康孕妇(40例)作为健康对照组。记录患者一般情况及实验室检测结果,检测外周血清s Eng及s Flt-1水平。所有患者定期随访,记录分娩及新生儿情况。结果外周血清s Eng及s Flt-1水平由高至低分别为重度PE组[(7 345.02±772.73)、(866.08±203.24)ng/L]、轻度PE组[(5 547.08±564.06、(603.99±138.37)ng/L]及健康对照组[(1 840.93±300.71)、(252.68±83.03)ng/L],差异有统计学意义(P<0.001)。轻度(或重度)PE组血清s Eng及s Flt-1水平呈正相关,s Eng及s Flt-1水平分别与平均动脉压、24 h尿蛋白定量、血清肌酐、纤维蛋白原、脐动脉收缩末期峰值与舒张末期峰值比、脐动脉阻力指数值呈正相关,与凝血酶原时间、新生儿体质量、胎盘质量呈负相关(P<0.05)。PE患者外周血清s Eng水平<5 000 ng/L及≥5 000 ng/L时,发生严重并发症比率分别为6.8%、40.4%;当外周血清s Flt-1水平及s Flt-1水平<700 ng/L及≥700 ng/L时,发生严重并发症比率分别为14.0%、37.0%;差异均有统计学意义(P<0.01)。结论血清s Eng及s Flt-1水平升高反映PE患者疾病严重程度加重,并与不良妊娠结局相关。
Objective To investigate the changes of serum soluble Endoglin (s Eng) and soluble Fms-like tyrosine kinase (s Flt-1) in patients with preeclampsia (PE) and its clinical significance . Methods Ninety-six PE patients were reviewed retrospectively from June 2009 to June 2014 in Suining Central Hospital. According to the severity of the disease, the patients were divided into mild PE group (n = 54) and severe PE group (n = 42) Pregnant women (40 cases) served as healthy control group. The general condition of patients and laboratory test results were recorded and the levels of s Eng and s Flt-1 in peripheral blood were detected. Regular follow-up of all patients, recording childbirth and neonatal conditions. Results The levels of s Eng and s Flt-1 in peripheral blood from high to low were severe PE group [(7 345.02 ± 772.73), (866.08 ± 203.24) ng / L], mild PE group [(5447.08 ± 564.06, (P <0.001). The levels of serum in the mild (or severe) PE group were significantly lower than those in the control group (P <0.001) s Eng and s Flt-1 levels were positively correlated with s Eng and s Flt-1 levels, respectively, with mean arterial pressure, 24 h urinary protein, serum creatinine, fibrinogen, umbilical artery end-systolic and diastolic peak ratio, Arterial resistance index was positively correlated with prothrombin time, neonatal body weight, placental weight was negatively correlated (P <0.05) .SPE levels of peripheral sPE <5 000 ng / L and ≥ 5000 ng / L , And the rates of serious complications were 6.8% and 40.4% respectively. The rates of severe complications when peripheral blood serum s Flt-1 levels and s Flt-1 levels were less than 700 ng / L and ≥ 700 ng / L were 14.0% , 37.0%, respectively (P0.01) .Conclusion The increase of serum s Eng and s Flt-1 level reflects the aggravation of disease severity in patients with PE and is associated with adverse pregnancy outcomes.