子痫前期孕妇血清sFlt-1、FGF-19水平与妊娠结局的关系研究

Associations between serum sFlt-1 and FGF-19 levels and pregnancy outcomes in preeclampsia

摘要:

目的 探讨子痫前期孕妇血清可溶性血管内皮生长因子受体1（sFlt-1）、成纤维细胞生长因子19（FGF-19）水平与妊娠结局的关系。方法 选取2021年1月—2024年1月邯郸市第一医院收治的113例子痫前期孕妇作为研究对象，根据患者病情将其分为轻度组（n =72）和重度组（n =41），另外选取103健康孕妇作为对照组。收集所有孕妇的基本资料，检测其血清sFlt-1、FGF-19水平。对所有子痫前期孕妇进行随访，根据随访结果分为正常妊娠组和不良妊娠组。采用多因素一般Logistic回归分析筛选不良妊娠结局的危险因素，采用受试者工作特征（ROC）曲线评估sFlt-1、FGF-19水平对妊娠结局的诊断价值。结果 重度组患者血清sFlt-1、FGF-19水平均高于轻度组和对照组（P <0.05）。正常妊娠组的收缩压、舒张压、24 h尿蛋白定量、sFlt-1水平及FGF-19水平均低于不良妊娠组（P <0.05）。正常妊娠组和不良妊娠组的年龄、孕前体质量指数、产次、分娩孕周、肌酐、尿素氮、尿酸、胆固醇、甘油三酯比较，差异均无统计学意义（P >0.05）。多因素一般Logistic回归分析结果显示：收缩压高［O^R =1.072（95% CI：1.015，1.134）］、24 h尿蛋白定量高［O^R =16.830（95% CI：3.015，93.937）］、sFlt-1水平高［O^R =1.006（95% CI：1.003，1.009）］及FGF-19水平高［O^R =1.047（95% CI：1.017，1.079）］均是不良妊娠结局的危险因素（P <0.05）。ROC曲线分析结果显示，联合检测曲线下面积为0.928（95% CI：0.880，0.975），敏感性为88.6%（95% CI：0.733，0.968），特异性为85.9%（95% CI：0.762，0.927）。结论 血清sFlt-1、FGF-19水平与子痫前期患者的疾病进展密切相关，对妊娠结局有较高的预测价值。

Abstract:

Objective To investigate the relationship between serum soluble vascular endothelial growth factor receptor-1 (sFlt-1) and fibroblast growth factor-19 (FGF-19) levels and pregnancy outcomes in preeclampsia.Methods In this study, 113 preeclamptic women admitted between January 2021 and January 2024 were categorized into mild (n = 72) and severe (n = 41) groups, with 103 healthy pregnant women as controls. Baseline characteristics and serum sFlt-1/FGF-19 levels were recorded. Preeclamptic patients were followed and stratified by pregnancy outcome (normal vs. adverse). Multivariable logistic regression identified risk factors for adverse outcomes; receiver operating characteristic (ROC) curves assessed the diagnostic value of sFlt-1 and FGF-19.Results Serum sFlt-1 and FGF-19 levels were significantly elevated in the severe group versus mild and control groups (P < 0.05). The normal outcome group exhibited lower systolic blood pressure (SBP), diastolic blood pressure (DBP), 24-h urinary protein, sFlt-1, and FGF-19 levels versus the adverse outcome group (P < 0.05). Age, pre-pregnancy BMI, parity, gestational age at delivery, creatinine, urea nitrogen, uric acid, cholesterol, and triglycerides showed no intergroup differences (P > 0.05). Multivariable analysis identified elevated SBP [O^R = 1.072 (95% CI: 1.015, 1.134) ], 24-h urinary protein [O^R = 16.830 (95% CI: 3.015, 93.937) ], sFlt-1 [O^R = 1.006 (95% CI: 1.003, 1.009) ], and FGF-19 [O^R = 1.047 (95% CI: 1.017, 1.079) ] as independent risk factors for adverse outcomes (P < 0.05). ROC analysis demonstrated that sFlt-1/FGF-19 combination predicted adverse outcomes with an AUC of 0.928 (95% CI: 0.880, 0.975), sensitivity of 88.6% (95% CI: 0.733, 0.968), and specificity of 85.9% (95% CI: 0.762, 0.927).Conclusion Serum sFlt-1 and FGF-19 levels are strongly associated with preeclampsia severity and serve as valuable predictors of adverse pregnancy outcomes.