2024 年第 8 期 第 19 卷

可溶性fms样酪氨酸激酶1与胎盘生长因子比值及维生素D水平和晚发型子痫前期患者疾病严重程度及妊娠结局的相关性研究

Study on the correlation between the ratio of soluble fms-like tyrosine kinase-1 to placental growth factor and vitamin D level with disease severity and pregnancy outcome in patients with late-onset preeclampsia

作者：李昕1梁超2王克芳1

英文作者：Li Xin1 Liang Chao2 Wang Kefang1

单位：1首都医科大学附属北京安贞医院妇产科，北京100029；2山东省青岛市妇女儿童医院妇产科，青岛266000

英文单位：1Department of Obstetrics and Gynecology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Department of Obstetrics and Gynecology Qingdao Women and Children′s Hospital Shandong Province Qingdao 266000 China

关键词：子痫前期；可溶性fms样酪氨酸激酶1与胎盘生长因子比值；维生素D

英文关键词：Preeclampsia;Ratioofsolublefms-liketyrosinekinase-1toplacentalgrowthfactor;VitaminD

• 摘要：

• 目的 探讨可溶性fms样酪氨酸激酶1与胎盘生长因子比值（sFlt-1/PLGF）及维生素D水平和晚发型子痫前期孕妇疾病严重程度及妊娠结局的相关性。方法 收集2021年7月至2023年12月于首都医科大学附属北京安贞医院妇产科进行产前检查和分娩的121例晚发型子痫前期患者的临床资料进行回顾性研究。根据病情严重程度分为重度组（61例）和非重度组（60例）。于孕34周后测定血清sFlt-1/PLGF及25-羟基维生素D［25-（OH）-D］水平，跟踪随访记录研究对象包括24 h尿蛋白水平、分娩孕周、新生儿体重等在内的妊娠结局。结果 重度组患者血清sFlt-1/PLGF高于非重度组［38.20(21.66,69.22)比25.59(16.74,51.54)］，差异有统计学意义（P＜0.05）。重度组患者血清25-（OH）-D水平低于非重度组，但差异无统计学意义（P>0.05）。重度组患者血清sFlt-1/PLGF与新生儿体重呈负相关（r=-0.267，P=0.038），与24 h尿蛋白水平呈正相关性（r=0.377，P=0.003），而与分娩孕周无明显相关性（P=0.645）。结论 与非重度子痫前期患者相比，重度子痫前期患者血清sFlt-1/PLGF明显升高，而2组血清维生素D水平相似。此外，重度子痫前期患者sFlt-1/PLGF与24 h尿蛋白水平呈正相关、与新生儿体重呈负相关，提示血清sFlt-1/PLGF对不良妊娠结局可提供预测作用，本研究或为临床上早期诊断、早期治疗子痫前期提供新思路、新方法。

• Objective To investigate the correlation between the ratio of soluble fms-like tyrosine kinase-1 to placental growth factor (sFlt-1/PLGF) and vitamin D level with disease severity and pregnancy outcome in pregnant women with late-onset preeclampsia. Methods  The clinical data of 121 patients with late-onset preeclampsia who underwent prenatal examination and delivery in Department of Obstetrics and Gynecology, Beijing Anzhen Hospital, Capital Medical University from July 2021 to December 2023 were collected for a retrospective study. According to the severity of the disease, they were divided into severe group (61 cases) and non-severe group (60 cases). After 34 weeks of pregnancy, serum sFlt-1/PLGF and 25-(OH)-D level were measured, and the pregnancy outcomes of the study subjects, including 24 h urine protein levels, gestational weeks of delivery, and newborn weight, were tracked and recorded. Results  The serum sFlt-1/PLGF in the severe group was higher than that in the non-severe group［38.20(21.66,69.22) vs 25.59(16.74,51.54)］(P<0.05). The serum 25-(OH)-D level in the severe group was lower than that in the non-severe group(P>0.05). The serum sFlt-1/PLGF in severe group was negatively correlated with neonatal weight(r=-0.267, P=0.038) and positively correlated with 24 h urine protein level(r=0.377, P=0.003), but not significantly correlated with gestational age at delivery (P=0.645). Conclusion  Compared with patients with non-severe preeclampsia, serum sFlt-1/PLGF in patients with severe preeclampsia is significantly higher, but there is no significant difference in serum vitamin D level between the two groups. In addition, serum sFlt-1/PLGF in patients with severe preeclampsia is positively correlated with 24 h urinary protein level and negatively correlated with neonatal weight, suggesting that serum sFlt-1/PLGF may play a role in the prediction of adverse pregnancy outcomes. This study may provide new ideas and methods for early diagnosis and early treatment of preeclampsia.