论文部分内容阅读
目的探讨血清可溶性血管内皮生长因子受体1的变化对妊娠期糖尿病患者胎儿生长受限的早期预测价值。方法选择2011年1月至2012年4月广州市妇女儿童医疗中心100例孕28～30w妊娠期糖尿病患者,采用酶联免疫吸附检测法检测血清血管内皮生长因子(VEGF)及其可溶性血管内皮生长因子受体(sFlt-1)水平,随访至分娩,发生胎儿生长受限(FGR)者21例(FGR组),出现巨大儿者27例(巨大儿组),胎儿发育正常者52例(对照组)。结果 FGR组血清VEGF、sFlt-1分别为(26.21±5.84)ng/L、(13.01±3.22)μg/L,巨大儿组分别为(28.77±2.72)ng/L、(7.72±5.13)μg/L,对照组分别为(27.53±4.16)ng/L、(8.98±4.36)μg/L,3组VEGF水平比较,差异无统计学意义(P>0.05),FGR组与巨大儿组及对照组sFlt-1水平比较,差异有统计学意义(分别P<0.01,P<0.05);巨大儿组与对照组sFlt-1水平比较,差异无统计学意义(P>0.05)。以sFlt-1水平12.86μg/L为界限值,预测FGR发生的灵敏度为85.71%,特异度为94.95%,阳性预测值为81.82%,阴性预测值为96.15%。结论检测孕妇血清sFlt-1水平也许可以作为预测妊娠期糖尿病患者出现胎儿生长受限的早期指标。
Objective To investigate the early predictive value of serum soluble vascular endothelial growth factor receptor 1 in fetal growth restriction in gestational diabetes mellitus. Methods From January 2011 to April 2012, 100 pregnant women with gestational diabetes of 28-30 w in Guangzhou Women and Children Medical Center were enrolled in this study. Serum vascular endothelial growth factor (VEGF) and its soluble vascular endothelial growth factor (VEGF) were detected by enzyme-linked immunosorbent assay 21 cases (FGR group) with fetal growth restriction (FGR) were followed up until delivery. There were 27 cases of huge children (macrosomia group) and 52 cases of normal fetal development (control group) group). Results The serum levels of VEGF and sFlt-1 in FGR group were (26.21 ± 5.84) ng / L and (13.01 ± 3.22) μg / L respectively, while those in giant group were (28.77 ± 2.72) ng / L and L and control groups were (27.53 ± 4.16) ng / L and (8.98 ± 4.36) μg / L, respectively. There was no significant difference in VEGF levels between the three groups (P> 0.05) sFlt-1 levels, the difference was statistically significant (P <0.01, P <0.05, respectively). There was no significant difference in the sFlt-1 levels between the macrosomia group and the control group (P> 0.05). The sensitivity of FGR was 85.71%, the specificity was 94.95%, the positive predictive value was 81.82%, and the negative predictive value was 96.15% at the limit of sFlt-1 level of 12.86μg / L. Conclusion Detecting serum sFlt-1 levels in pregnant women may be an early indicator of fetal growth restriction in gestational diabetes.