血管生成因子(PlGF和sFlt-1)在子痫前期诊断中的作用

The Role of Angiogenic Factors (PlGF and sFlt-1) in the Diagnosis of Preeclampsia

摘要: 目的：本研究旨在评估血管生成因子胎盘生长因子(PlGF)和可溶性fms样酪氨酸激酶1 (sFlt-1)在子痫前期早期诊断中的临床应用价值。方法：本前瞻性队列研究纳入了140名孕10~38周的单胎孕妇，其中29名随后诊断为子痫前期，111名保持正常妊娠。采集孕妇血清样本，使用酶联免疫吸附测定(ELISA)检测PlGF和sFlt-1水平。计算sFlt-1/PlGF比值，并进行统计分析以评估这些标志物的诊断性能。结果：子痫前期组PlGF水平显著低于对照组(P < 0.05)，而sFlt-1水平和sFlt-1/PlGF比值显著高于对照组(P < 0.05)。sFlt-1/PlGF比值在预测子痫前期方面表现最佳，敏感性为89.66%、特异性为91.89%，AUC为0.94 (95% CI: 0.74~0.97)。结论：血清PlGF和sFlt-1水平，特别是sFlt-1/PlGF比值，是子痫前期早期诊断的有效生物标志物。这些指标可以帮助临床医生及早识别高风险孕妇，从而改善孕产妇和胎儿的预后。

Abstract: Objective: This study aimed to evaluate the clinical utility of angiogenic factors, placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1), in the early diagnosis of preeclampsia. Methods: This prospective cohort study enrolled 140 singleton pregnant women at 10–38 weeks of gestation, including 29 subsequently diagnosed with preeclampsia and 111 with normal pregnancies. Maternal serum samples were collected, and PlGF and sFlt-1 levels were measured using enzyme-linked immunosorbent assay (ELISA). The sFlt-1/PlGF ratio was calculated, and statistical analyses were performed to assess the diagnostic performance of these biomarkers. Results: The preeclampsia group exhibited significantly lower PlGF levels (P < 0.05) and significantly higher sFlt-1 levels and sFlt-1/PlGF ratios (P < 0.05) compared to the control group. The sFlt-1/PlGF ratio demonstrated the best predictive performance for preeclampsia, with a sensitivity of 89.66%, specificity of 91.89%, and an area under the curve (AUC) of 0.94 (95% CI: 0.74~0.97). Conclusion: Serum PlGF and sFlt-1 levels, particularly the sFlt-1/PlGF ratio, serve as effective biomarkers for the early diagnosis of preeclampsia. These indicators may assist clinicians in the timely identification of high-risk pregnancies, thereby improving maternal and fetal outcomes.