Plasma concentrations of angiogenic/anti-angiogenic factors have prognostic value in women presenting with suspected preeclampsia to the obstetrical triage area: a prospective study.
Plasma concentrations of angiogenic/anti-angiogenic factors have prognostic value in women presenting with suspected preeclampsia to the obstetrical triage area: a prospective study.
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DOI：
10.3109/14767058.2013.806905
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发表时间：
2014-01
期刊：
影响因子：
--
通讯作者：
Hassan SS
中科院分区：
文献类型：
--
作者：
Chaiworapongsa T;Romero R;Korzeniewski SJ;Cortez JM;Pappas A;Tarca AL;Chaemsaithong P;Dong Z;Yeo L;Hassan SS
前瞻性确定母体血浆胎盘生长因子（PlGF）、可溶性内皮糖蛋白（sEng）和可溶性血管内皮生长因子受体-1和-2（sVEGFR-1和-2）浓度在鉴别需要早产（PTD）或发生不良结局的疑似先兆子痫（PE）患者中的预后价值。这项前瞻性队列研究纳入了85名连续患者，这些患者在20-36周时被诊断为“排除PE”。患者分类为：1）保持稳定直至足月的患者（n=37）;和2）发生重度PE并需要PTD的患者（n=48）。通过ELISA测定PlGF、sEng和sVEGFR-1和-2的血浆浓度。PlGF/sVEGFR-1 ≤0.05中位数倍数（MoM）或PlGF/sEng ≤0.07 MoM的患者更有可能因PE而早产[校正比值比（aOR）7.4和8.8]，并发生母体（aOR 3.7和2.4）或新生儿并发症（aOR 10.0和10.1）。在妊娠<34周的患者中，PlGF/sVEGFR-1 ≤ 0.035 MoM或PlGF/sEng ≤0.05 MoM的敏感性为89%（16/18），特异性为96%（24/25），阳性试验的似然比为22，以确定在两周内分娩的患者。将PlGF/sVEGFR-1比率添加到标准临床测试中以3%的固定假阳性率（p=0.004）提高了用于鉴定在两周内由于PE而分娩的患者的灵敏度。在血浆PlGF/sVEGFR-1比值≤ 0.035 MoM、0.036-0.34 MoM和≥ 0.35 MoM的患者中，PTD < 34周的发生率分别为94%、27%和7%。血管生成/抗血管生成因子的测定对产科分诊区疑似先兆子痫的患者具有预后价值，可用于识别需要早产和有不良孕产妇/新生儿结局风险的患者。
To prospectively determine the prognostic value of maternal plasma concentrations of placental growth factor (PlGF), soluble endoglin (sEng) and soluble vascular endothelial growth factor receptors-1 and −2 (sVEGFR-1 and −2) in identifying patients with suspected preeclampsia (PE) who require preterm delivery (PTD) or develop adverse outcomes. This prospective cohort study included 85 consecutive patients who presented to the obstetrical triage area at 20–36 weeks with a diagnosis of ‘rule out PE’. Patients were classified as: 1) those who remained stable until term (n=37); and 2) those who developed severe PE and required PTD (n=48). Plasma concentrations of PlGF, sEng and sVEGFR-1 and −2 were determined by ELISA. Patients with PlGF/sVEGFR-1 ≤0.05 multiples of the median (MoM) or PlGF/sEng ≤0.07 MoM were more likely to deliver preterm due to PE [adjusted odd ratio (aOR) 7.4 and 8.8], and to develop maternal (aOR 3.7 and 2.4) or neonatal complications (aOR 10.0 and 10.1). Among patients who presented <34 weeks of gestation, PlGF/sVEGFR-1 ≤ 0.035 MoM or PlGF/sEng ≤0.05 MoM had a sensitivity of 89% (16/18), specificity of 96% (24/25) and likelihood ratio for a positive test of 22 to identify patients who delivered within two weeks. The addition of the PlGF/sVEGFR-1 ratio to standard clinical tests improved the sensitivity at a fixed false-positive rate of 3% (p=0.004) for the identification of patients who were delivered due to PE within two weeks. Among patients who had a plasma concentration of PlGF/sVEGFR-1 ratio ≤ 0.035 MoM, 0.036–0.34 MoM and ≥ 0.35 MoM, the rates of PTD < 34 weeks were 94%, 27% and 7%, respectively. The determination of angiogenic/anti-angiogenic factors has prognostic value in patients presenting to the obstetrical triage area with suspected preeclampsia for the identification of those requiring preterm delivery and at risk for adverse maternal/neonatal outcomes.
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DOI：
10.1016/0002-9378(89)90096-3
发表时间：
1989-01-01
影响因子：
9.8
作者：
DEBOER, K;TENCATE, JW;TREFFERS, PE
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