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目的探讨子痫前期患者血清中血管内皮生长因子(VEGF)及妊娠相关血浆蛋白A(PAPP-A)表达及临床意义。方法以2014年1月-2016年10月在该院产科门诊行常规产前检查(产检)并分娩的子痫前期孕妇98例为研究对象,并根据子痫前期严重程度将其分为轻度组(49例)和重度组(49例),同时选择同期在该院产科门诊行产检并住院分娩的49例正常孕妇作为对照组。采用酶联免疫吸附试验(ELISA)对3组孕妇血清中的PAPP-A水平和VEGF水平进行测定,分析二者与子痫前期严重程度的相关性。结果重度组新生儿出生体质量低于轻度组和对照组,差异有统计学意义(F=-2.118,P<0.05);重度组和轻度组患者血清VEGF、PAPP-A和24 h尿蛋白值均高于对照组,差异有统计学意义(F=-2.149、-2.254、-2.237,均P<0.05);重度组的PAPP-A与24 h尿蛋白值均高于轻度组,差异有统计学意义(t=-2.042、-2.105,均P<0.05);Speraman相关分析显示,血清VEGF和PAPP-A呈明显的正相关(t=-0.624,P<0.05)。结论在子痫前期的发生发展过程中,血清VEGF与PAPP-A均参与其中,且二者之间呈正相关关系,互相影响。PAPP-A能够准确反映子痫前期病情的严重程度,能够作为反映孕晚期子痫前期病情严重程度的指标。
Objective To investigate the expression of serum vascular endothelial growth factor (VEGF) and pregnancy related plasma protein A (PAPP-A) in patients with preeclampsia and its clinical significance. Methods From January 2014 to October 2016, 98 pregnant women with preeclampsia underwent routine antenatal examination (childbirth) and obstetrical clinic in obstetrics and gynecology department of the hospital from January 2014 to October 2016. The patients were divided into three groups according to the severity of preeclampsia (49 cases) and severe group (49 cases). At the same time, 49 normal pregnant women undergoing maternity examination and hospital delivery during the same period were selected as the control group. Serum levels of PAPP-A and VEGF in three groups of pregnant women were measured by enzyme linked immunosorbent assay (ELISA), and the relationship between them and the severity of preeclampsia was analyzed. Results The birth weight of newborns in severe group was lower than that in mild group and control group (F = -2.118, P <0.05). Serum levels of VEGF, PAPP-A and 24 h urine in severe group and mild group (F = -2.149, -2.254, -2.237, all P <0.05). The values of PAPP-A and 24-hour urinary protein in severe group were higher than those in mild group The difference was statistically significant (t = -2.042, -2.105, all P <0.05). Speraman correlation analysis showed that there was a significant positive correlation between serum VEGF and PAPP-A (t = -0.624, P <0.05). Conclusions Serum VEGF and PAPP-A are involved in the development of preeclampsia, and they are positively correlated with each other and affect each other. PAPP-A can accurately reflect the severity of preeclampsia, and can be used as an indicator of the severity of preeclampsia in third trimester of pregnancy.