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早发子痫前期患者血浆胎盘生长因子水平与围生结局的研究
华绍芳;李月琴
0
(天津医科大学第二医院)
摘要:
目的:探讨早发型子痫前期(EOPE)患者血浆胎盘生长因子(PlGF)水平与围生结局的关系。方法:纳入经剖宫产终止妊娠的125例EOPE患者。双抗体夹心酶标免疫分析法(ELISA)检测分娩当日血浆PlGF水平,根据EOPE患者血浆PlGF水平分为:≤12 pg/ml为PlGF≤12 pg/ml组(n=64),>12 pg/ml为PlGF>12 pg/ml组(n=61);测定新生儿出生后1小时内外周动脉血血气分析及乳酸(LAC)水平。比较两组患者血常规及生化指标及与围生结局的关系。结果:(1)PlGF≤12 pg/ml组患者Hb、HCT、24小时尿蛋白定量、尿素氮(BUN)、肌酐(Cr)水平高于PlGF>12 pg/ml组(P<0.05);而白蛋白(ALB)水平低于PlGF>12 pg/ml组,差异均有统计学意义(P<0.05)。(2)PlGF≤12 pg/ml组分娩孕周小于PlGF>12 pg/ml组;而羊水过少、羊水粪染、小于胎龄儿(SGA)的比例均高于PlGF>12 pg/ml组,差异均有统计学意义(P<0.05)。(3)PlGF≤12 pg/ml组新生儿出生体质量、1分钟Apgar评分、pH值、血钙、碱剩余(BE)均低于PlGF>12 pg/ml组;而LAC水平高于PlGF>12 pg/ml组;新生儿入住NICU的天数多于PlGF>12 pg/ml组,差异均有统计学意义(P<0.05)。结论:EOPE患者PlGF测定对于预测围生结局具有一定临床价值,PlGF≤12 pg/ml的高危EOPE患者发生肾功能受损明显增加,羊水过少、羊水粪染、SGA及新生儿窒息比例增加,且新生儿更易发生酸碱失衡及物质代谢紊乱,临床需要加强关注。
关键词:  子痫前期  早发  胎盘生长因子  围生结局  乳酸
DOI:
基金项目:
The Study on Maternal Plasma Placental Growth Factor Level and the Perinatal Outcome in Early-Onset Pre-Eclampsia Patients
HUA Shaofang;LI Yueqin
(The Second Hospital of Tianjin Medical University)
Abstract:
Objective: To investigate the relationship between plasma placental growth factor( PlGF) levels and perinatal outcomes in patients with early onset preeclampsia( EOPE). Methods: 125 patients with EOPE undergoing cesarean section were enrolled in this study. Enzyme-linked immunosorbent assay( ELISA) was used to detect the level of maternal plasma PlGF.According to the plasma PlGF level,≤12 pg/ml was divided into PlGF≤12 pg/ml group( n = 64) and PlGF>12 pg/ml was in PlGF>12 pg/ml group( n = 61).The blood gas analysis and the level of lactic acid( LAC) were measured within 1 hour after fetal birth.The routine and biochemical indexes of two groups and their relation with perinatal outcomes were compared. Results:(1) In PlGF ≤ 12 pg/ml EOPE group,the Hb,HCT,24 h urine protein level,BUN and Cr levels were higher than those in PlGF>12 pg/ml group( P<0. 05).While the ALB level was lower than that of PlGF>12 pg/ml group( P<0. 05).(2)The gestational age of PlGF≤12 pg/ml group was less than that of PlGF>12 pg/ml group,but the proportion of oligohydramnios,meconium stained amniotic fluid and less than gestational age infants( SGA) were all higher than those of PlGF>12 pg/ml group( P<0. 05).(3)In the PlGF≤12 pg/ml group,neonatal birth weight( BW),1 minute Apgar score,p H,serum Ca,BE were all lower than those in PlGF>12 pg/ml group.But the level of LAC and the NICU hospital stay were all higher than those in PlGF>12 pg/ml group( P<0. 05).Conclusions: In EOPE patients,plasma PlGF level has certain clinical value in predicting perinatal outcome.If PlGF is ≤12 pg/ml,the maternal renal dysfunction may be more obviously,and there is higher incidence of oligohydramnios,meconium stained fluid,SGA and neonatal asphyxia,and the newborn is more susceptible to metabolic imbalance and acid-base disorders.Mother and child care should be strengthened.
Key words:  Pre-eclampsia  Early-onset  Placentalgrowthfactor  Perinataloutcome  Lacticacid

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