Fractional excretion of angiogenic factors in women with severe preeclampsia
Fractional excretion of angiogenic factors in women with severe preeclampsia
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DOI：
10.1097/01.aog.0000207698.74104.4f
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发表时间：
2006-05-01
影响因子：
7.2
通讯作者：
Buhimschi, Irina A.
中科院分区：
文献类型：
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作者：
Buhimschi, Catalin S.;Magloire, Lissa;Buhimschi, Irina A.
目的：我们估计的分数排泄可溶性fms样酪氨酸激酶1（sFIT-1），血管内皮生长因子，胎盘生长因子的严重先兆子痫妇女在疾病的临床appearance.METHODS时间：水平游离sFIT-1，血管内皮生长因子，胎盘生长因子测定从时间匹配的血清，尿液样本来自64名妇女在以下组别：非妊娠育龄妇女（n = 9）、健康妊娠对照（n = 13）、轻度先兆子痫妇女（n = 15）和重度先兆子痫妇女（n = 27）。将尿中血管生成因子的浓度标准化为肌酐，并计算排泄分数。血管生成因子、蛋白尿、非特异性蛋白尿和尿蛋白与肌酐比值之间的相关性进行了估计：与轻度先兆子痫妇女（P = .007）或妊娠对照组（P < .001）相比，重度先兆子痫妇女的尿血管内皮生长因子（P = .01）和血管内皮生长因子的排泄分数增加了一倍以上。重度子痫前期孕妇血清、尿液及部分排泄sFIt-1水平均显著高于其他妊娠组（P <0.001）。相反，重度先兆子痫妇女血清胎盘生长因子水平低于健康孕妇（P <0.05）和轻度先兆子痫组（P <0.05）。重度先兆子痫妇女胎盘生长因子、白蛋白、蛋白尿和随机尿总蛋白/肌酐比值的排泄分数增加。在重度先兆子痫妇女中，蛋白尿与血管内皮生长因子（r = 0.30，P = 0.127）或sFIT-1（r = 0.35，P = 0.07）的排泄分数之间没有相关性。胎盘生长因子排泄分数与随机尿总蛋白/肌酐比值显著相关，（r = 0.60，P = .002），非特异性蛋白尿（r = 0.50，P = .01）。重度先兆子痫的特征在于血管生成因子尤其是血管内皮生长因子的排泄分数增加，这可能反映了两种可能具有叠加效应的独立现象：“内源性”肾生成和肾小球“渗漏。"
OBJECTIVE: We estimated the fractional excretions of soluble fms-like tyrosine kinase 1 (sFIt-1), vascular endothelial growth factor, and placental growth factor of severely preeclamptic women at the time of disease clinical manifestation.METHODS: Levels of free sFIt-1, vascular endothelial growth factor, and placental growth factor were measured by immunoassay from time-matched serum-urine samples from 64 women in the following groups: nonpregnant reproductive aged (n = 9), healthy pregnant controls (n = 13), mildly preeclamptic women (n = 15), and women with severe preeclampsia (n = 27). Urinary concentrations of angiogenic factors were normalized to creatinine and fractional excretions calculated. Correlations were estimated between fractional excretions of angiogenic factors, albuminuria, nonspecific proteinuria and urine protein-to-creatinine ratio.RESULTS: Severely preeclamptic women had more than double urinary vascular endothelial growth factor (P = .01) and fractional excretion of vascular endothelial growth factor compared with mildly preeclamptic women (P = .007) or pregnant controls (P < .001). Serum, urine and fractional excretion levels of sFIt-1 were much higher among severely preeclamptic women compared with all the other pregnant groups (P < .001). Conversely, severely preeclamptic women had lower serum placental growth factor levels compared with healthy pregnant women (P < .05) and mildly preeclamptic groups (P < .05). Severely preeclamptic women had increased fractional excretions of placental growth factor, albumin, proteinuria, and random urine total protein/creatinine ratio. Among severely preeclamptic women there was no correlation between proteinuria and fractional excretion of vascular endothelial growth factor (r = 0.30, P = .127) or sFIt-1 (r = 0.35, P = .07). There was a significant correlation between fractional excretion for placental growth factor, random urine total protein/creatinine ratio (r = 0.60, P = .002), and nonspecific proteinuria (r = 0.50, P = .01).CONCLUSION: Severe preeclampsia is characterized by increased fractional excretion of angiogenic factors and especially of vascular endothelial growth factor, likely reflecting 2 separate phenomena that may have additive effects: "endogenous" renal production and glomerular "leakage."