Influence of the vascular endothelial growth factor on the development of severe pre-eclampsia or HELLP syndrome
Influence of the vascular endothelial growth factor on the development of severe pre-eclampsia or HELLP syndrome
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DOI：
10.1007/s00404-010-1704-x
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发表时间：
2011-09-01
影响因子：
2.6
通讯作者：
Bussen, Dieter
中科院分区：
文献类型：
--
作者：
Bussen, Stefanie;Bussen, Dieter
本研究的目的是比较妊娠合并子痫前期或HELLP综合征患者和正常妊娠对照组孕妇血清中血管内皮生长因子(VEGF)水平，并探讨其与胎盘激素和营养功能的关系。30例同胎龄健康孕妇作为对照组。孕妇血清中的血管内皮生长因子浓度通过一种商用的夹心免疫测定法(Quantikine(A(R))，研发系统，威斯巴登，德国)进行测定。采用放射免疫法测定血清雌二醇、雌三醇和孕酮水平，研究组平均血清血管内皮生长因子浓度(172.0+/-A98.9pg/ml)显著高于对照组(41.4+/-A30.5pg/ml)(U检验：P<；0.001)。在研究的HELLP综合征患者亚组中，血管内皮生长因子水平显著低于重度子痫前期患者(109.2+/-A68.5pg/ml对219.0+/-A72.9)。U检验：P<；0.05)。在所有研究和对照组患者中，血清雌二醇与血管内皮生长因子浓度呈显著正相关(Spearman等级相关：P<；0.05)。局部缺氧引起的胎盘表达增加和胎盘外产物增多，如胎儿或母体血管系统内皮细胞、巨噬细胞或平滑肌细胞，可能是重度子痫前期或HELLP综合征患者血清血管内皮生长因子水平升高的原因。
The aim of this study was to compare the maternal serum concentrations of the vascular endothelial growth factor (VEGF) in patients whose pregnancies were complicated by pre-eclampsia or HELLP syndrome with those of healthy pregnant controls and to study its relationship with the hormonal and nutritive function of the placenta.The study group consisted of 30 primaparae who suffered from either severe pre-eclampsia (n = 16) or from HELLP syndrome (n = 14). 30 healthy pregnant woman of the same gestational age served as control group. Maternal serum VEGF concentrations were determined by using a commercially available Sandwich immunoassay (Quantikine(A (R)), R&D Systeme, Wiesbaden, Germany). Estradiol, estriol and progesterone serum levels were measured by performing a radioimmunoassay (Biermann, Bad Nauheim, Germany).The mean serum VEGF concentration of the study group (172.0 +/- A 98.9 pg/ml) was significantly increased, compared with the mean serum VEGF concentration of the control group (41.4 +/- A 30.5 pg/ml) (U test: P < 0.001). In the subgroup of the study patients with HELLP syndrome, significantly lower VEGF levels were measured than in patients suffering from severe pre-eclampsia (109.2 +/- A 68.5 pg/ml vs. 219.0 +/- A 72.9. U test: P < 0.05). In all study and control patients, a significantly positive correlation between serum estradiol and VEGF concentration could be found (Spearman's rank correlation: P < 0.05).An increased placental expression due to local hypoxia and an increased extraplacental production, e.g., in endothelial cells of the fetal or maternal vascular system, in macrophages or in smooth muscle cells, could be discussed as causes for the raised serum VEGF concentration in patients suffering from severe pre-eclampsia or HELLP syndrome.