The course of angiogenic factors in early- vs. late-onset preeclampsia and HELLP syndrome.
The course of angiogenic factors in early- vs. late-onset preeclampsia and HELLP syndrome.
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DOI：
10.1515/jpm-2012-0248
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发表时间：
2013-09-01
影响因子：
2.4
通讯作者：
Stepan H
中科院分区：
文献类型：
--
作者：
Schaarschmidt W;Rana S;Stepan H
先兆子痫 (PE) 被认为是一种均一进展性疾病，但在早期（<34 周）或晚期（≥34 周）发病的患者中表现出不同的临床进展模式。可溶性fms样酪氨酸激酶1（sFlt-1）和胎盘生长因子（PlGF）等血管生成因子与PE的临床病程密切相关。我们评估了不同胎龄诊断为 PE 的女性在 PE 临床病程中的 sFlt-1 和 PlGF 水平。这项回顾性研究纳入了 34 名 PE 患者，其中 11 名患者患有 HELLP 综合征（历时 3 年）。从入院到分娩期间完成了 sFlt-1 和 PlGF 的系列测量。值表示为平均值±标准差。早发性 PE 女性的入院平均孕龄明显较低，为 29±3 周，而晚发性 PE 患者的平均入院孕龄为 37±1 周。妊娠平均延长时间为 6 天，两组相似。与晚发性肺栓塞女性相比，早发性肺栓塞女性的 sFlt-1 增加幅度更大（每天 11% vs. 3%，P<0.05），PlGF 水平下降幅度更大（每天 21% vs. 10%，P=0.30），导致 sFlt-1/PlGF 比率增加幅度更大（每天 23% vs. 8%，P<0.05）。 HELLP 综合征患者表现出类似的进展模式。与早发早发性肺栓塞的女性中观察到的逐渐恶化的临床病程类似，血管生成谱发生变化，导致这些女性日复一日地处于更加抗血管生成的状态。这些发现可能对识别女性进行适当的患者管理以及基于降低 sFlt-1 水平的未来可能的治疗具有影响。
Preeclampsia (PE) is considered a uniformly progressive disease, however, it shows a different pattern of clinical progression in patients with early (<34 weeks) or late (≥34 weeks) onset of the disease. Angiogenic factors such as soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) are closely related to the clinical course of PE. We evaluated sFlt-1 and PlGF levels in the clinical course of PE in women admitted with a diagnosis of PE at different gestational ages. This retrospective study included 34 patients with PE, of which 11 patients had HELLP syndrome (over a period of 3 years). Serial measurements of sFlt-1 and PlGF were completed from admission until delivery. Values are presented as mean±standard deviation. Mean gestational age of admission among women with early onset PE was significantly lower, at 29±3 weeks compared to 37±1 weeks among patients with late onset disease. Mean prolongation of pregnancy was 6 days, which was similar within the two groups. Compared to women with late onset PE, women with early-onset PE had a greater increase in sFlt-1 (11% vs. 3% per day, P<0.05), greater decrease in PlGF levels (21% vs. 10% per day, P=0.30), resulting in a much higher increase in sFlt-1/PlGF ratio (23% vs. 8% per day, P<0.05). Patients with HELLP syndrome showed comparable progression patterns. In a similar way to the progressively worsening clinical course observed in women with early onset PE, there were changes in the angiogenic profile that leads to a more anti-angiogenic state in these women with each passing day. These findings may have implications in identification of the women for appropriate patient management and possible future therapies based on the reduction of sFlt-1 levels.
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影响因子：
37.8
作者：
Thadhani, Ravi;Kisner, Tuelay;Benzing, Thomas
通讯作者：
Benzing, Thomas
DOI：
10.1016/j.ejogrb.2004.11.015
发表时间：
2005-09-01
期刊：
EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY
影响因子：
--
作者：
Staff, AC;Braekke, K;Holthe, MR
通讯作者：
Holthe, MR
影响因子：
9.8
作者：
Robinson, Christopher J.;Johnson, Donna D.;Wang, Wei
通讯作者：
Wang, Wei
影响因子：
7.2
作者：
Berg, Cynthia J.;MacKay, Andrea R.;Callaghan, William M.
通讯作者：
Callaghan, William M.
影响因子：
1.8
作者：
Romero, Roberto;Nien, Jyh Kae;Karumanchi, S. Ananth
通讯作者：
Karumanchi, S. Ananth