关键词: 血管生成调节因子, 氧化应激, 子痫前期, 妊娠期高血压

Abstract:

Objective To assess the correlation of angiogenesis regulation factors [placental growth factor（PLGF） and soluble fms-like tyrosine kinase-1（sFlt-1）] and oxidative stress markers [8-epi-prostaglandin F2alpha（8-epi-PGF2α） and total antioxidant capacity（TAC）] with adverse pregnancy in gestational hypertension（GH） and preeclampsia（PE） patients.Methods Pregnant women who received antenatal care,including 65 GH patients and 84 PE patients,and 50 healthy women were enrolled. PLGF,sFlt-1 and 8-epi-PGF2α were determined by enzyme-linked immunosorbent assay（ELISA）. TAC was measured by ferric reducing antioxidant power（FRAP）. The characteristics and pregnancy outcomes before and after delivery were collected.Results At baseline（within 24 h）,the levels of sFlt-1 and 8-epi-PGF2α and sFlt-1/PLGF ratio in control,GH and PE groups increased in turn（P<0.001）,while the levels of PLGF and TAC decreased in turn（P<0.001）. Compared with those at baseline,the levels of TAC and PLGF in control,GH and PE groups were increased in 48 h after delivery（P<0.05,P<0.001）,while sFlt-1 and 8-epi-PGF2α levels and sFlt-1/PLGF ratio were decreased（P<0.001）. The proportion of fetal hip exposure during delivery in PE group was higher than those in control and GH groups（P<0.05）. The proportions of placental previa,placental exfoliation,intrauterine fetal death（IUFD）,intrauterine growth retardation（IUGR）,prenatal hemorrhage（APH） and preterm premature rupture of membranes（PPROM） were higher in PE group than those in control group（P<0.05）. The cesarean section rates in PE and GH groups were higher than that in control group（P<0.05）. The stillbirth,premature delivery,postpartum hemorrhage（PPH）and maternal mortality in PE group were higher than those in control group（P<0.05）. The neonatal birth weight for patients with PE and IUGR was lower than those for patients with severe PE,PE and GH and women with normal pregnancy（P<0.001）. The sFlt-1 and 8-epi-PGF2α levels and sFlt-1/PLGF ratios in PE combined with IUFD,PE combined with placental exfoliation,PE combined with IUGR,PE combined with placental previa and hemolysis,elevated liver enzymes and low platelet（HELLP） syndrome were higher than those in PE patients（P<0.05）. There was a negative correlation of IUGR,placental exfoliation/previa,IUFD,stillbirth and PPH with PLGF and TAC（P<0.05）,but there were positive correlations of IUGR,placental exfoliation/previa,IUFD,stillbirth and PPH with sFlt-1 and 8-epi-PGF2α in PE group（P<0.05）.Conclusions The imbalance between the levels of angiogenesis regulation factors and oxidative stress markers correlates with adverse pregnancy in PE patients,which can be used as an early warning of adverse pregnancy.

Key words: Angiogenesis regulation factor, Oxidative stress, Preeclampsia, Gestational hypertension