CAJ | 학술논문

目的：探讨血管内皮生长因子（VEGF）、可溶性血管内皮生长因子受体1（sFlt－1）和胰岛素生长因子－1（IGF－1）与妊娠高血压综合征（妊高征）母婴预后的关系。方法选取妊高征患者85例作为妊高征组，按照妊高征的严重程度分为妊娠高血压19例、子痫前期轻度36例和子痫前期重度30例。选择同期孕产期健康体检的孕妇30例和健康体检的妇女20例分别作为正常妊娠组和健康对照组。检测3组sFlt－1、VEGF、sFlt－1／VEGF和IGF－1水平，分析妊高征患者sFlt－1、VEGF、sFlt－1／VEGF和IGF－1水平与疾病严重程度和胎儿结局的关系。结果妊高征组和正常妊娠组的VEGF和IGF－1水平均明显低于健康对照组（P均＜0．01），而妊高征组明显低于正常妊娠组（P＜0．01），VEGF和IGF－1水平随着妊高征患者病情的加重而降低（P均＜0．01）；妊高征组和正常妊娠组的sFlt－1和sFlt－1／VEGF水平均明显高于健康对照组（P均＜0．01），而妊高征组的水平明显高于正常妊娠组（P＜0．01），sFlt－1和sFlt－1／VEGF水平随着妊高征患者病情的加重而升高（ P＜0．01）。妊高征患者的血清sFlt－1／VEGF水平与胎儿生长受限、胎儿窘迫、新生儿窒息和新生儿死亡的发生率呈正相关，血清IGF－1水平与胎儿生长受限、胎儿窘迫、新生儿窒息和新生儿死亡的发生率呈负相关。结论妊高征患者血清sFlt－1／VEGF水平明显升高，而IGF－1水平明显降低，并随着病情的加重升高或降低更为明显，二者参与妊娠高血压疾病的发生发展，与胎儿的预后有关。
목적：탐토혈관내피생장인자（VEGF）、가용성혈관내피생장인자수체1（sFlt－1）화이도소생장인자－1（IGF－1）여임신고혈압종합정（임고정）모영예후적관계。방법선취임고정환자85례작위임고정조，안조임고정적엄중정도분위임신고혈압19례、자간전기경도36례화자간전기중도30례。선택동기잉산기건강체검적잉부30례화건강체검적부녀20례분별작위정상임신조화건강대조조。검측3조sFlt－1、VEGF、sFlt－1／VEGF화IGF－1수평，분석임고정환자sFlt－1、VEGF、sFlt－1／VEGF화IGF－1수평여질병엄중정도화태인결국적관계。결과임고정조화정상임신조적VEGF화IGF－1수평균명현저우건강대조조（P균＜0．01），이임고정조명현저우정상임신조（P＜0．01），VEGF화IGF－1수평수착임고정환자병정적가중이강저（P균＜0．01）；임고정조화정상임신조적sFlt－1화sFlt－1／VEGF수평균명현고우건강대조조（P균＜0．01），이임고정조적수평명현고우정상임신조（P＜0．01），sFlt－1화sFlt－1／VEGF수평수착임고정환자병정적가중이승고（ P＜0．01）。임고정환자적혈청sFlt－1／VEGF수평여태인생장수한、태인군박、신생인질식화신생인사망적발생솔정정상관，혈청IGF－1수평여태인생장수한、태인군박、신생인질식화신생인사망적발생솔정부상관。결론임고정환자혈청sFlt－1／VEGF수평명현승고，이IGF－1수평명현강저，병수착병정적가중승고혹강저경위명현，이자삼여임신고혈압질병적발생발전，여태인적예후유관。
Objective It is to observe the levels of vascular endothelial growth factor ( VEGF) , soluble vascular endotheli-al growth factor receptor 1 (sFlt-1) and insulin-like growth factor-1 (IGF-1) in patients with pregnancy-induced hyper-tension and their impact on the outcome of fetus .Methods 85 patients with pregnancy-induced hypertension were observed as pregnancy-induced hypertension group , and were divided into 19 cases in pregnancy-induced hypertension , 36 cases in mild preeclampsia and 30 cases in severe preeclampsia according to the severity of pregnancy-induced hypertension .30 healthy pregnant women and 20 health women were selected as normal pregnancy group and healthy control group at the same period . The levels of sFlt-1, VEGF, sFlt-1/VEGF and IGF-1 were detected in the three groups , and their relationship with sever-ity of the disease and fetal outcomes were analyzed .Results The levels of VEGF and IGF -1 in pregnancy-induced hyperten-sion group and normal pregnancy group were significantly lower than those in healthy control group (P<0.01), and the levels of those in pregnancy-induced hypertension group were significantly lower than those in normal pregnancy group (P<0.01), and the levels of VEGF and IGF -1 in patients with pregnancy-induced hypertension decreased as the severity increased ( P<0.01).The levels of sFlt-1 and sFlt-1/VEGF in pregnancy-induced hypertension group and normal pregnancy group were significantly higher than those in healthy control group (P<0.01), and the levels of those in pregnancy-induced hypertension group significantly higher compared with normal pregnancy group (P<0.01), and the levels of sFlt-1 and sFlt-1/VEGF in patients with pregnancy-induced hypertension increased as the severity of pregnancy-induced hypertension increased ( P <0.01 ) .There were positively correlated among sFlt -1/VEGF levels and fetal growth restriction , the incidence of fetal dis-tress, neonatal asphyxia and neonatal mortality;at the same time, there were negatively correlated among IGF -1 levels and fetal growth restriction , fetal distress , neonatal asphyxia and neonatal mortality rates .Conclusion The levels of sFlt-1/VEGF in patients with pregnancy-induced hypertension increase , whereas IGF -1 levels appear lower , and the levels of those are more obvious with increasing severity and they are involved in hypertensive disorders of pregnancy progression , and related to the fetus prognosis .