Alterations in placental growth factor levels before and after the onset of preeclampsia are more pronounced in women with early onset severe preeclampsia
Alterations in placental growth factor levels before and after the onset of preeclampsia are more pronounced in women with early onset severe preeclampsia
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DOI：
10.1291/hypres.30.151
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发表时间：
2007-02-01
影响因子：
5.4
通讯作者：
Suzuki, Mitsuaki
中科院分区：
文献类型：
--
作者：
Ohkuchi, Akihide;Hirashima, Chikako;Suzuki, Mitsuaki
已经确定，在先兆子痫妇女中，血清胎盘生长因子（PlGF）降低，可溶性fms样酪氨酸激酶-1（sFit-1）增加。然而，目前还没有关于先兆子痫发病时间与PIGF和sFit-1变化之间关系的研究。此外，PIGF和sFlt-1水平尚未使用其特定于每个胎龄的参考值进行评估。在这项研究中，我们重新评估了血清PIGF和sFit-1水平之前和之后的早期和晚发型重度先兆子痫的临床表现，使用我们最近的纵向研究中开发的新的参考值。对34例转诊的重度子痫前期患者在出现临床表现后立即采集血液标本，对8例在我院接受常规检查的患者在出现临床表现前后均采集血液标本。在28周和37周时，与血压正常的对照组相比，患有早期和晚期先兆子痫的妇女都显示出PIGF降低和sFit-1水平增加（n=68）。然而，与晚发型相比，早发性先兆子痫患者具有更高的低PIGF（参考值<第5百分位数）和高sFlt-1（>=第95百分位数）发生率（低PIGF：93%对55%;高sFlt-1：100%对60%）。log（10）PIGF（r=0.574，p < 0.001）和log（10）（sFlt-1/PIGF）（r=-0.556，p < 0.001）与先兆子痫发作的周数相关。在子痫前期发病前，早发性子痫前期患者PIGF低表达率为100%（5/5），晚发性子痫前期患者PIGF低表达率为0%（0/2）（p=0.048）。因此，早发性重度子痫前期女性在子痫前期发病前后PIGF水平的变化可能比晚发性重度子痫前期女性更明显。
It has been established that the serum placental growth factor (PIGF) decreases and the soluble fms-like tyrosine kinase-1 (sFit-1) increases in women with preeclampsia. However, there have been no studies on the relation between preeclampsia onset time and the changes in PIGF and sFit-1. Furthermore, the PIGF and sFlt-1 levels have not been evaluated using their reference values specific to each gestational age. In this study we reevaluated the serum PIGF and sFit-1 levels before and after the clinical manifestation of early and late onset severe preeclampsia using the new reference values developed in our recent longitudinal study. Blood specimens were obtained immediately after the clinical manifestation of severe preeclampsia in 34 referred women, and both before and after the clinical manifestation in 8 women receiving a routine checkup at our institute. Both women with early and those with late preeclampsia showed decreased PIGF and increased sFit-1 levels compared to normotensive controls at 28 and 37 weeks (n=68). However, those with early onset preeclampsia had a higher incidence of low PIGF (< 5th percentile on the reference values) and high sFlt-1 (>= 95th percentile) than those with late onset (low PIGF: 93% vs. 55%; high sFit-1: 100% vs. 60%). log(10)PIGF (r=0.574, p < 0.001) and log(10)(sFlt-1/PIGF) (r=-0.556, p < 0.001) were correlated with the week of onset of preeclampsia. Before the onset of preeclampsia, the incidence rate of low PIGF in the women with early onset preeclampsia was 100% (5/5), whereas that in the women with late onset preeclampsia was 0% (0/2) (p=0.048). Therefore, alterations in the PIGF levels both before and after the onset of preeclampsia may be more pronounced in women with early onset than those with late onset severe preeclampsia.