sFlt-1、IGFBP-3、PAPP-A在稽留流产中的表达及意义

目的研究可溶性FMS样酪氨酸激酶-1(sFlt-1)、胰岛素样生长因子结合蛋白3(IGFBP-3)、妊娠相关血浆蛋白A(PAPP-A)在稽留流产中的表达及意义。方法选取2015年6月至2017年6月在重庆市两江新区第一人民医院接受治疗的稽留流产患者40例纳入稽留流产组;早期流产患者40例纳入早期流产组;另外选取进行体检的健康妊娠期产妇20例作为正常组。收集3组研究对象的绒毛组织,采用免疫组化染色处理,酶联免疫吸附测定sFlt-1、IGFBP-3、PAPP-A表达,并在显微镜下观察其阳性表达情况。结果正常组sFlt-1表达水平显著低于早期流产组和稽留流产组(P<0.05);稽留流产组sFlt-1表达水平低于早期流产组(P<0.05)。正常组IGFBP-3、PAPP-A表达水平显著高于早期流产组和稽留流产组(P<0.05);稽留流产组患者IGFBP-3、PAPP-A表达水平高于早期流产患者(P<0.05)。sFlt-1、IGFBP-3、PAPP-A三项联合检测敏感度、准确度高于sFlt-1、IGFBP-3、PAPP-A单一检测,特异度低于sFlt-1、IGFBP-3、PAPP-A单一检测(P<0.05)。结论sFlt-1、IGFBP-3、PAPP-A联合检测对稽留流产的诊断价值较高,sFlt-1、IGFBP-3、PAPP-A的异常表达参与了稽留流产的发展,为稽留流产的治疗提供一定的理论基础。

Expression and significance of sFlt-1,IGFBP-3 and PAPP-A in missed abortion

Objective To study the expression and significance of soluble FMS-like tyrosine kinase-1(sFlt-1),insulin-like growth factor binding protein 3(IGFBP-3)and pregnancy-related plasma protein A(PAPP-A)in missed abortion.Methods Totally 40 patients with missed abortion treated in first people′s hospital of Chongqing Liangjiang new district from June 2015 to June 2017 were selected as the missed abortion group,another 40 patients with early abortion in our hospital were as the early abortion group,and 20 healthy pregnant women undergoing physical examination in our hospital were selected as the normal group.The villi tissues of the three groups were collected and immunohistochemical staining was used.The expressions of sFlt-1,IGFBP-3 and PAPP-A were determined by ELISA,and the positive expressions were observed under the microscope.Results The expression level of sFlt-1 in the normal group was significantly lower than those in the early abortion group and the missed abortion group(P<0.05).The expression level of sFlt-1 in the missed abortion group was lower than that in the early abortion group(P<0.05).The expression levels of IGFBP-3 and PAPP-A in the normal group were significantly higher than those in the early abortion group and the missed abortion group(P<0.05).The expression levels of IGFBP-3 and PAPP-A in the missed abortion group were higher than those in the early abortion group(P<0.05).The sensitivity and accuracy of sFlt-1,IGFBP-3 and PAPP-A combined detection were higher than that of sFlt-1,IGFBP-3 and PAPP-A single detection,and the specificity was lower than those of sFlt-1 IGFBP-3 and PAPP-A single detection(P<0.05).Conclusion The combined detection of sFlt-1,IGFBP-3 and PAPP-A is of high diagnostic value for missed abortion.Abnormal expressions of sFlt-1,IGFBP-3 and PAPP-A are involved in the development of missed abortion,which provides a certain theoretical basis for the treatment of missed abortion.