血清sFlt-1/PlGF和胎盘CD146与子痫前期的相关性

Correlation of sFlt-1/PlGF and Placental CD146 with Preeclampsia

摘要: 目的：通过比较实验组(子痫前期患者)和对照组(正常妊娠孕妇)血清内可溶性酪氨酸激酶受体-1 (soluble fms-like tyrosine kinase-1, sFlt-1)与胎盘生长因子(Placental growth factor, PlGF)的改变及分娩后胎盘CD146的表达情况及血清中sFlt-1/PlGF值的变化与胎盘CD146的表达之间的关系，来探究与子痫前期发病的相关性。研究方法：收集2020年1月~2021年10月在山东省青岛市市立医院东院区产科就诊并诊断为子痫前期的剖宫产分娩患者55例为实验组，(子痫前期诊断标准及分类参照谢庆主编的《妇产科学》第九版)取同期经选择性剖宫分娩的正常孕妇60例作为对照组，应用酶联免疫吸附法检测血清中sFlt-1、PlGF及sFlt-1/PlGF值的变化，选取分娩后实验组与对照组胎盘所制蜡块，应用免疫组织化学法检测胎盘CD146的表达，共成功检测标本115例，分析与子痫前期相关性。结果：1) 实验组和对照组一般资料(身高、体重、年龄)差异无统计学意义(P > 0.05)。2) 实验组PlGF的水平为30.489 ± 7.250 (pg/ml)，对照组PlGF水平145.599 ± 137.658 (pg/ml)，实验组PlGF明显低于对照组，P < 0.001，差异具有统计学意义。3) 实验组sFlt-1水平为3828.496 ± 965.079 (pg/ml)，对照组sFlt-1水平为1522.012 ± 261.275 (pg/ml)，对照组的sFlt-1要显著低于实验组，P < 0.001，其差异有统计学价值。4) 实验组sFlt-1/PlGF水平为150.387 ± 116.903 (pg/ml)，对照组sFlt-1/PlGF水平为15.679 ± 7.505 (pg/ml)，实验组中sFlt-1/PlGF明显高于对照组，P < 0.05，差异具有统计学意义。5) 实验组胎盘CD146表达与对照组比较，实验组胎盘呈低表达或不表达，对照组呈高表达或强表达，差异具有统计学意义(P < 0.05)。6) 胎盘CD146表达情况与sFlt-1/PlGF具有相关性，P < 0.01，r = −0.934，差异具有统计学意义。

Abstract: Objective: By comparing the changes of soluble FMS-like Tyrosine kinase-1 (sFlt-1) in serum and Placental growth factor (PlGF), Placental CD146 expression after delivery, sFlt-1/PlGF changes in serum and Placental CD146 expression in the experimental group (preeclampsia) and the control group (normal pregnancy), explore the association with the onset of preeclampsia. Research meth-ods: Collect 55 patients with cesarean section delivery diagnosed with preeclampsia in January 2020 to October 2021 in maternity clinic, east campus, Qingdao Hospital in Shandong province as the experimental group. (The diagnostic criteria and classification of preeclampsia refer to the ninth edition of Obstetrics and Gynecology edited by Xie Qing). In the same period by the selective normal pregnant women in childbirth 60 cases as control group, the changes of serum sFlt-1, PlGF and sFlt-1/PlGF values were detected by ELISA. The expression of CD146 in the placenta of the ex-perimental group and control group was detected by immunohistochemistry after delivery. A total of 115 cases of placenta were successfully detected, and the correlation with preeclampsia was ana-lyzed. Results: 1) There was no significant difference in general information (height, weight and age) between the experimental group and the control group (P > 0.05). 2) The level of PlGF in the experimental group was 30.489 ± 7.250 (pg/ml), and that in the control group was 145.599 ± 137.658 (pg/ml). The level of PlGF in the experimental group was significantly lower than that in the control group, P < 0.001, and the difference was statistically significant. 3) The level of SFLT-1 in the experimental group was 3828.496 ± 965.079 (pg/ml), and that in the control group was 1522.012 ± 261.275 (pg/ml). The level of sFlt-1 in the control group was significantly lower than that in the experimental group, P < 0.001, and the difference was statistically significant. 4) The level of sFlt-1/PlGF in the experimental group was 150.387 ± 116.903 (pg/ml), and the level of sFlt-1/PlGF in the control group was 15.679 ± 7.505 (pg/ml). The sFLT-1/PlGF in the experimental group was significantly higher than that in the control group, P < 0.05. The difference was statisti-cally significant. 5) Compared with the control group, the expression of CD146 in the placenta of the experimental group was low or not high, while that of the control group was high or strong, and the difference was statistically significant (P < 0.05). 6) Placental CD146 expression was correlated with sFlt-1/PlGF, P < 0.01, r = −0.934, the difference was statistically significant.