血清sFlt-1､PLGF水平及比值变化预测孕妇轻度子痫前期发病的Meta分析

目的:探讨血清可溶性血管内皮生长因子受体-1(soluble fms-like tyrosine kinase-1,sFlt-1)?胎盘生长因子(placental growth factor,PLGF)水平及比值变化与轻度子痫前期发病关系?方法:检索万方?CNKI?PubMed?Embase和Cochrane收集1994—2016年国内外公开发表的关于血清sFlt-1?PLGF水平及比值变化与轻度子痫前期关系的中英文病例对照研究,剔除不符合标准的文献,对纳入的文章采用Review Manager 5.3软件对结果进行统计分析?结果:共纳入文献17篇,其中中文文献14篇,英文文献3篇?血清sFlt-1表达水平与轻度子痫前期的关系的异质性检验I 2 = 96%,P < 0.000 01,存在明显的异质性,合并效应SMD=4.89(95%CI:3.60~6.17),P < 0.000 01,差异有统计学意义?血清PLGF表达水平与轻度子痫前期的关系的异质性检验I 2 = 93%,P < 0.000 01,存在明显的异质性,合并效应SMD=-2.32(95%CI:-2.91~-1.72),P < 0.000 01,差异有统计学意义?轻度子痫前期组和正常对照组血清sFlt-1/PLGF比值异质性检验I 2 = 98%,P < 0.000 01,合并效应SMD=1.95(95%CI:0.50~3.40),P < 0.000 01,差异有统计学意义?结论:PLGF与轻度子痫前期的发病具有密切关系,血清sFlt-1的表达水平与轻度子痫前期有关,sFlt-1以及sFlt-1/PLGF比值可以作为辅助诊断轻度子痫前期的有效指标

Meta-analysis of the relationship between the serum levels of sFlt-1, PLGF and their ratio for diagnosis of mild preeclampsia in pregnant women

Objective:To investigate the relationship between the serum levels of sFlt-1,PLGF and their ratio in mild preeclampsia. Methods:We searched Wanfang,CNKI,PubMed,Embase and Cochran,and published domestic and foreign controlled studies about the relationship between the serum levels of sFlt-1,PLGF and their ratio in mild preeclampsia from 1994 to 2014. Then,we excluded non-compliant documents,and statistically analyzed the results of included studies using Review Manager 5.3 software. Results:A total of 17 studies were included in this study,including 14 Chinese studies and 3 English studies. Heterogeneity test about the serum levels of sFlt-1 expression and the relationship between mild preeclampsia was I2=96%,P< 0.000 01,and the heterogeneity was significant. The combined effect of SMD=4.89(95%CI:3.60~6.17),P < 0.000 01,the difference was statistically significant. Heterogeneity test about the serum levels of PLGF expression and the relationship between mild preeclampsia was I2=93%,P < 0.000 01,the heterogeneity was significant. The combined effect of SMD=-2.32(95%CI:-2.91~-1.72),P < 0.000 01,the difference was statistically significant. Heterogeneity test about the serum levels of sFlt-1/PLGF ratio expression and the relationship between preeclampsia was I2=98%,P < 0.000 01,the heterogeneity was significant,the combined effect of SMD=1.95(95%CI:0.50~3.40),P < 0.000 01,the difference was statistically significant. Conclusion:PLGF is highly correlated with the occurrence and development of mild preeclampsia;the serum levels of sFlt-1 expression associated with mild preeclampsia;sFlt-1 and sFlt-1/PLGF ratio can be used as an effective index for diagnosis of mild preeclampsia.