脐动脉超声血流、MMP-9、PLGF检测在评估重度子痫前期患者妊娠结局中的应用

目的 分析脐动脉超声血流、基质金属蛋白酶-9(MMP-9)、胎盘生长因子(PLGF)检测对重度子痫前期患者妊娠结局的评估作用.方法 回顾性分析本院2015年6月至2017年1月住院分娩的142例重度子痫前期患者围产儿相关资料,根据妊娠结局将其分为围产儿不良结局组与非不良结局组,比较两组出生孕周、出生体重、胎盘重量、脐动脉超声血流监测指标、MMP-9及PLGF水平.结果 围产儿不良结局发生率29.58％;围产儿不良结局组出生孕周、出生体重、胎盘重量、胎盘MMP-9、PLGF表达水平均显著小于非不良结局组;脐动脉收缩期、舒张期血流比值(UA-S/D)、UA搏动指数(UA-PI)、UA阻力指数(UA-RI)均显著大于非不良结局组,差异有统计学意义(P＜0.05);Spearman相关分析显示出生孕周与出生体重、胎盘重量、MMP-9 、PLGF、UA-S/D均显著相关(P＜0.05),MMP-9与PLGF表达正相关,与UA-S/D负相关(P ＜0.01);PLGF与UA-S/D负相关(P＜0.01).结论 重度子痫前期患者围产儿不良结局发生率较高,胎盘MMP-9、PLGF水平降低,脐动脉超声血流指标异常与围产儿不良结局密切相关.

Application of Umbilical Artery Ultrasonic Doppler Flow Imaging,Detection of MMP-9 and PLGF in the Evaluating Pregnancy Outcomes of Patients with Severe Preeclampsia

Objective To evaluate the effect of umbilical artery (UA) ultrasonic Doppler flow imaging,detection of matrix metalloproteinase-9 (MMP-9) and placental growth factor(PLGF) on evaluate pregnancy outcomes of patients with severe preeclampsia.Methods The perinatal data of 142 patients with severe preeclampsia who delivered in our hospital from June 2015 to January 2017 were retrospectively analyzed.According to the pregnancy outcomes,the patients were divided into the perinatal adverse outcome group and non-adverse outcome group.The gestational age,birth weight,placental weight,monitoring indexes of UA ultrasonic Doppler flow imaging,MMP-9 and PLGF levels were compared between the two groups.Results The incidence of perinatal adverse outcomes was 29.58％.The gestational age,birth weight,placental weight and expression levels of placental MMP-9 and PLGF in the perinatal adverse outcome group were significantly smaller or lower than while the ratio of umbilical artery systolic and diastolic blood flow (UA-S/D),UA pulsatility index (UA-PI)and UA resistance index (UA-RI)were significantly higher than those in the non-adverse outcomes group (P ＜ 0.05).Spearman correlation analysis showed that gestational age was significantly correlated with birth weight,placental weight,MMP-9,PLGF and UA-S/D (P ＜ 0.05).The expression of MMP-9 was positivly correlated with PLGF,and negatively correlation with UA-S/D(P ＜0.01).PLGF was negatively correlated with UA-S/D (P ＜ 0.01).Conclusion The incidence of perinatal adverse outcomes increases in patients with severe preeclampsia,and the levels of MMP-9 and PLGF in placenta decreases.The abnormality of umbilical artery blood flow indexes is highly related to the perinatal adverse outcomes.