sCD40L、sVEGFR2、sFlt-1和PLGF与子痫前期相关性研究-现代医学

sCD40L、sVEGFR2、sFlt-1和PLGF与子痫前期相关性研究

单位：上海中医药大学附属曙光医院妇产科, 上海 201203

分类号：R714.25

出版年·卷·期（页码）：2019·47·第八期（978-982）

摘要：

目的：研究可溶性白细胞分化抗原配体（sCD40L）、血管内皮细胞生长因子受体2（sVEGFR2）、溶性fms-样酪氨酸激酶1（sFlt-1）和胎盘生长因子（PLGF）在子痫前期发病中的作用和意义。方法：选取2014年6月至2018年4月本院收治的子痫前期孕妇的90例，和正常健康孕妇30例为对照组。其中轻度子痫前期组、早发重度子痫前期组和晚发重度子痫前期组各30例，患者应用硫酸镁联合低分子肝素治疗两个疗程。检查患者一般资料、分娩情况、治疗前后凝血功能和肾功能变化。收集患者血清并采用ELISA法检测患者血清中sCD40L、sVEGFR2、sFlt-1和PLGF浓度水平的表达，检查其与子痫前期的相关性。结果：与对照组相比，轻度子痫前期组、早发重度子痫前期组和晚发重度子痫前期组患者sCD40L和sFlt-1水平随着疾病的程度加重显著升高，sVEGFR2和PLGF水平随着疾病的程度加重显著降低，差异具有统计学意义（P<0.05）。与治疗前相比，患者应用硫酸镁联合低分子肝素治疗后，轻度子痫前期组、早发重度子痫前期组和晚发重度子痫前期组患者sCD40L和sFlt-1水平显著降低，sVEGFR2和PLGF水平显著升高，差异具有统计学意义（P<0.05）.通过直线相关分析结果发现，轻度子痫前期组、早发重度子痫前期组和晚发重度子痫前期组与患者血液内sCD40L和sFlt-1存在显著的正性直线相关关系，与sVEGFR2和PLGF在显著的负性直线相关关系，P<0.01。结论：sCD40L、sVEGFR2、sFlt-1和PLGF与子痫前期患者的严重程度明显相关，在子痫前期的发病过程中起到重要的作用。

Objective:To study the role and significance of soluble leukocyte differentiation antigen ligand (sCD40L), Vascular Endothelial Growth Factor Receptor 2 (sVEGFR2), soluble fms-like tyrosine kinase 1 (sFlt-1) and placenta growth factor (PLGF) in the pathogenesis of preeclampsia. Methods:90 cases of pre eclampsia pregnant women in our hospital from June 2014 to April 2018 were enrolled into experimental groupand 30 healthy pregnant women were selected as control group. There were 30 cases of mild preeclampsia, early severe preeclampsia and late severe preeclampsia, respectively. The patients were treated with magnesium sulfate combined with low molecular weight heparin. General information, delivery condition, coagulation function and renal function before and after treatment were examined. The patient serum was collected and the expression of sCD40L, sVEGFR2, sFlt-1 and PLGF in serum were detected by ELISA, and its correlation with preeclampsia was examined.Results:Compared with the control group, the levels of sCD40L and sFlt-1 in the mild preeclampsia group andthe early severe preeclampsia group and the late severe preeclampsia group increased significantly with the degree of disease, and the level of sVEGFR2 and PLGF decreased significantly with the severity of the disease, the difference was statistically significant (P<0.05). The levels of sCD40L and sFlt-1 in patients with mild preeclampsia, early severe preeclampsia and late onset severe preeclampsia were significantly lower in patients with mild preeclampsia, early severe preeclampsia and late onset severe preeclampsia, and the levels of sVEGFR2 and PLGF were significantly increased (P<0.05). The results of a linear correlation analysis were compared with those before treatment with low molecular weight heparin. It was found that there was a significant positive linear correlation between the mild preeclampsia group, the early severe preeclampsia group and the late severe preeclampsia group and the patients with sCD40L and sFlt-1 in the blood, and a significant negative linear correlation with sVEGFR2 and PLGF(P<0.01). Conclusion:sCD40L, sVEGFR2, sFlt-1 and PLGF are significantly correlated with the severity of preeclampsia, and play an important role in the pathogenesis of preeclampsia.

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