子痫前期患者血清FN及sFlt-1的水平及临床意义研究

目的 探讨子痫前期（preeclampsia，PE）患者血清纤维连接蛋白（fibronectin，FN）及可溶性Fms样酪氨酸激酶-1（soluble Fms-like tyrosine kinase-1，sFlt-1）水平变化及其临床意义。方法 回顾性纳入笔者医院2009年6月～2014年12月就诊的PE患者107例，分为轻度PE组（n=60）及重度PE组（n=47），纳入健康孕妇（n=40）作为对照。采集病史资料及实验室指标，检测血清FN及sFlt-1。分析FN及sFlt-1与临床指标的相关性，以及不良妊娠结局的影响因素。结果 重度PE组FN及sFlt-1水平分别为1225.63±203.89ng/L、863.44±194.90ng/L，显著高于轻度PE组（655.85±200.22ng/L、604.72±132.55ng/L）及健康对照组（110.97±44.98ng/L、252.68±83.03ng/L）。轻度及重度PE组FN与sFlt-1呈显著正相关（r=0.561，P=0.001；r=0.571，P=0.000）。FN（或sFlt-1）与平均动脉压、24h尿蛋白、Cr、纤维蛋白原、脐动脉S/D值及RI值呈显著正相关（P均<0.01），与PT、新生儿体重、胎盘重量呈显著负相关（P均<0.05）。高FN或sFlt-1水平的PE患者妊娠不良结局发生率更高。结论 PE及sFlt-1水平升高反映PE患者疾病严重程度加重，且与妊娠不良结局相关。

Levels of Serum Fibronectin and Soluble Flt-1 and Their Clinical Implication in Patients with Preeclampsia

Objective To investigate the levels of serum fibronectin (FN) and soluble Fms-like tyrosine kinas (sFlt-1) and their clinical implication in patients with preeclampsia (PE). Methods One hundred and seven patients with PE were enrolled in our hospital from June 2009 to December 2014, who were divided into mild PE group (n=60) and severe PE group (n=47), while healthy pregnant women (n=40) served as control. The general situation, laboratory testing, serum FN and sFlt-1 were recorded. All patients were regularly followed up with recording of delivery and neonatal situation. Results The FN and sFlt-1 levels were highest in the severe PE group (1225.63±203.89ng/L, 863.44±194.90ng/L), in a descending order, followed by mild PE (655.85±200.22ng/L, 604.72±132.55ng/L) and control group (110.97±44.98ng/L, 252.68±83.03ng/L). The levels of FN were significantly correlated with sFlt-1 in mild or severe PE group (R=0.561, P=0.000; R=0.571, P=0.000). The FN (or sFlt-1) was significantly positively correlated with mean arterial pressure, urinary protein at 24h, Cr, fibrinogen, umbilical artery S/D value and RI value (P<0.01), but negatively correlated with PT, neonatal and placenta weight (P<0.05). Patients with high FN and sFlt-1 levels had higher risk of severe complications (P<0.01). Conclusion Serum levels of FN and sFlt-1 in PE patients indicate the severity of disease and adverse outcomes of pregnancy.