重度子痫前期患者血管内皮生长因子及其受体-1水平变化及意义

目的检测早发型和晚发型重度子痫前期患者血清和胎盘中血管内皮生长因子（vascular endothelial growth factor,VEGF）及血管内皮生长因子受体-1（soluble vascular endothelial growth factor receptors-1,sFlt-1）水平,探讨其在重度子痫前期发病中的作用机制。方法 20例早发型重度子痫前期患者为早发重度组,20例晚发型重度子痫前期患者为晚发重度组,20例正常晚期妊娠者为正常妊娠组,采用ELISA法检测3组血清VEGF及sFlt-1水平,同时应用免疫组织化学SP法检测胎盘组织中VEGF及sFlt-1的阳性表达率。结果血清VEGF水平及胎盘VEGF阳性表达率早发重度组（（27.5±3.6）ng/L和15%）、晚发重度组（（36.2±3.2）ng/L和30%）均低于正常妊娠组（（45.5±3.7）ng/L和45%）（P〈0.05）,早发重度组低于晚发重度组（P〈0.05）;血清sFlt-1水平及胎盘sFlt-1阳性表达率早发重度组（（42.2±3.2）ng/L和60%）、晚发重度组（（30.2±2.5）ng/L和45%）均高于正常妊娠组（（14.7±2.7）ng/L和10%）（P〈0.05）,早发重度组高于晚发重度组（P〈0.05）。结论 VEGF水平低表达及sFlt-1水平高表达可能与重度子痫前期的严重程度相关,在重度子痫前期发生、发展中起重要作用。

Changes and clinical significance of vascular endothelial growth factor and soluble vascular endothelial growth factor receptor-1 in severe preeclampsia patients

Objective To explore the mechanism of vascular endothelial growth factor （VEGF） and soluble vascular endothelial growth factor receptor-1 （sFlt-1） in severe preeclampsia by detecting their levels in serum and placenta in pregnant women with early- and late-onset severe preeclampsia. Methods The levels of serum VEGF and SFlt-1 were detected by ELISA technique in 20 patients with early-onset severe preeclampsia （early-onset group）, 20 with late-onset severe preeclampsia （late-onset group） and 20 normal pregnant women （control group）. The expressions of VEGF and SFlt-1 in placenta were detected by SP method. Results The levels and positive rates of VEGF in serum and placenta were lower in early-onset group （（27.5±3.6） ng/L, 15%） than those in late-onset group （（36.2±3.2） ng/L, 30%） （P〈0.05）, both of which were lower than those in control group （（45.5±3.7） ng/L, 45%） （P〈0.05）. The levels and positive rates of sFlt-1 in serum and placenta were higher in early-onset group （（42.2±3.2） ng/L, 60%） than those in late-onset group （（30. 2±2. 5） ng/L, 45%） （P〈0.05）, both of which were higher than those in control group （（14.7±2.7） ng/L, 10%） （P〈0.05）. Conclusions Low-expressed VEGF and high-expressed sFlt-1 are correlated with the severity of severe preeclampsia, and may play an important role in the development and progression of severe preeclampsia.