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目的探讨妊娠相关蛋白A(PAPP-A)、胎盘生长因子(PLGF)、可溶性血管内皮生长因子(sFlt-1)在预测妊娠期高血压疾病发病风险中的价值。方法采用酶联免疫法(ELISA)检测66例孕妇不同孕周的血清PAPP-A、PLGF和sFlt-1水平。其妊娠期高血压组33例(观察组),正常妊娠组33例。采用荧光定量PCR及Western blot方法分别检测胎盘组织中PLGF、sFlt-1 mRNA及蛋白表达。结果在孕程的全部采血孕周,观察组孕妇血清sFlt-1水平均明显高于对照组,而PLGF均低于对照组。观察组各孕周内sFlt-1/PLGF均显著高于对照组。观察组胎盘组织sFlt-1 mRNA及蛋白表达水平明显高于对照组;PLGF mRNA及蛋白表达水平明显低于对照组。结论孕妇血清中PAPP-A、PLGF、sFlt-1水平变化能够作为诊断和预测妊娠期高血压疾病的临床客观指标。
Objective To investigate the value of PAPP-A, placental growth factor (PLGF) and soluble vascular endothelial growth factor (sFlt-1) in predicting the risk of developing hypertensive disorder complicating pregnancy. Methods Serum levels of PAPP-A, PLGF and sFlt-1 in 66 pregnant women at different gestational weeks were detected by enzyme-linked immunosorbent assay (ELISA). The gestational hypertension group 33 cases (observation group), normal pregnancy group 33 cases. Fluorescent quantitative PCR and Western blot were used to detect the expression of PLGF and sFlt-1 mRNA and protein in placenta. Results During the whole blood sampling during pregnancy, serum levels of sFlt-1 in the observation group were significantly higher than those in the control group, while PLGF in the observation group was lower than that in the control group. The sFlt-1 / PLGF in the observation group was significantly higher than that in the control group in each gestational week. The expression of sFlt-1 mRNA and protein in placenta of observation group was significantly higher than that in control group. The expression of PLGF mRNA and protein in placenta was significantly lower than that of control group. Conclusions The changes of serum PAPP-A, PLGF and sFlt-1 levels in pregnant women can be used as clinical objective indexes for the diagnosis and prediction of hypertensive disorder complicating pregnancy.