The use of angiogenic biomarkers to differentiate non-HELLP related thrombocytopenia from HELLP syndrome.
The use of angiogenic biomarkers to differentiate non-HELLP related thrombocytopenia from HELLP syndrome.
复制标题
使用血管生成生物标志物区分非 HELLP 相关血小板减少症和 HELLP 综合征。
DOI：
10.1080/14767050903184207
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Rana,Sarosh
中科院分区：
文献类型：
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作者：
Young,Brett;Levine,RichardJ;Salahuddin,Saira;Qian,Cong;Lim,Kee-Hak;Karumanchi,SAnanth;Rana,Sarosh
目的：子痫前期（PE）的诊断是通过临床标准进行的，在不典型的病例中，由于没有特异性的检查来确认或排除PE，因此诊断可能不准确。本研究旨在评估血管生成生物标志物sFlt 1、sEng和PlGF在区分妊娠期血小板减少症和免疫性血小板减少性紫癜（ITP）患者与HELLP导致的血小板减少症患者中的效用。（溶血、肝酶升高和血小板减少）综合征，方法：收集ITP和妊娠期血小板减少症患者（N= 9）的血清，与HELLP（N= 11）和PE（N= 11）患者进行比较。这些血管生成生物标志物的循环水平也通过胎龄与1564名从钙预防先兆子痫研究中随机选择的血压正常的妇女进行比较。与HELLP综合征患者相比，HELLP综合征患者的sEng水平（7.3 ± 3.8 ng/ml vs.15.5 ± 5 ng/ml，P <0.001）较低（8.7 ± 3.6 vs.34 ± 17，P< 0.001），PlGF水平（484 ± 412 vs.66.3 ± 44，P= 0.003）较高。PE患者的血管生成因子异常与HELLP综合征患者相似，提示有共同的发病机制。非HELLP血小板减少症患者的血管生成概况与血压正常对照组相似，而HELLP综合征患者的sFlt 1和sEng水平高于第90百分位数，低于第10百分位数PlGF.Conclusions。
Objective.Preeclampsia (PE) is diagnosed using clinical criteria and in atypical cases the diagnosis may be inaccurate as there are no specific tests to confirm or exclude PE. This study sought to evaluate the utility of angiogenic biomarkers, sFlt1, sEng and PlGF to distinguish patients with gestational thrombocytopenia and immune thrombocytopenic purpura (ITP) from patients with thrombocytopenia resulting from the HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome, a complication of severe PE.Methods.Serum was collected and the angiogenic biomarkers of patients with ITP and gestational thrombocytopenia (N= 9) were compared to patients with HELLP (N= 11) and PE (N= 11). Circulating levels of these angiogenic biomarkers were also compared by gestational age to 1564 randomly selected normotensive women from the Calcium for Preeclampsia Prevention study.Results.Patients with non-HELLP thrombocytopenia had lower sFlt1 (7.3 ± 3.8 ng/ml vs. 15.5 ± 5 ng/ml,P< 0.001), lower sEng (8.7 ± 3.6 vs. 34 ± 17,P< 0.001) and higher PlGF (484 ± 412 vs. 66.3 ± 44,P= 0.003) than patients with HELLP syndrome. Angiogenic factor abnormalities in patients with PE were similar to patients with HELLP syndrome, suggesting a common pathogenesis. Patients with non-HELLP thrombocytopenia had angiogenic profiles similar to normotensive controls, whereas patients with HELLP syndrome had levels higher than the 90th percentile for sFlt1 and sEng and lower than the 10th percentile for PlGF.Conclusions.Angiogenic biomarkers may be useful in excluding conditions that mimic PE.