Study On The Changes Of Serum PLGF Level And The Index Of Umbilical Blood Flow In Preeclampsia

Objectives:To observe the level differences of placental growth factor in peripheral venous blood and S/D ratio, PI, RI of umbilical artery flow between preeclampsia and normal pregnant women, and to discuss the mechanism of placental growth factor and umbilical artery blood flow index changes and their correlation in preeclampsia.Methods:This study adopted case-control study method. To determine the cubital vein serum levels of placental growth factor (PLGF) in 28 cases of normal pregnancy group,24 cases of mild preeclampsia group and 22 cases of severe preeclampsia group by mean of enzyme-linked immmunsobent assay (ELISA). To detect S/D ratio, PI, RI values of the umbilical artery blood flow in all pregnant women above by color doppler ultrasound. Using Excel 2007 and SPSS 19.0 statistical software package to organize, collate and analyse the data.Results:1. The differences of pregnant women’s age, pregnant times, productive times and gestational age among normal control group, mild preeclampsia group and severe preeclampsia group are not statistically significant (P>0.05).2. PLGF levels in venous blood serum of pregnant women in normal pregnancy, mild preeclampsia and severe preeclampsia are (91.61 ±30.73)pg/ml, (72.05±22.40)pg/ml and (43.82+16.79)pg/ml. The overall difference between the three groups was statistically significant (P<0.05). Further multiple comparisons results show that, the level of PLGF in peripheral venous blood serum in normal control group and mild preeclampsia group, normal control group and severe preeclampsia group, mild preeclampsia group and severe preeclampsia group were significantly different (P<0.05). Normal control group has the highest PLGF level; level of mild preeclampsia group second:the PLGF level of severe preeclampsia group minimum.3. The umbilical artery S/D value of the normal control group was 2.17±0.18, PI value was 0.76±0.09, RI value was 0.51±0.06. Mild preeclampsia group umbilical artery S/D value was 2.73 ±0.46, PI value was 0.86±0.12, RI value was 0.59±0.10. Severe preeclampsia group umbilical artery S/D value was 3.37+0.76, PI value was 1.03±0.23, RI value was 0.72±0.09. The overall differences of umbilical artery S/D, PI, RI between the three groups were statistically significant (P＜0.05). Further multiple comparisons results show that, the values of umbilical artery S/D, PI, RI in normal control group and mild preeclampsia group, normal control group and severe preeclampsia group, mild preeclampsia group and severe preeclampsia group were significantly different (P<0.05). Normal control group has the highest umbilical artery S/D, PI, RI values; values of mild preeclampsia group second; the umbilical artery S/D, PI, RI values of severe preeclampsia group minimum.4. In the normal pregnancy group, there was no correlation between the maternal serum level of PLGF and the umbilical artery S/D, PI, RI values (P>0.05); but in the preeclampsia group, there were negative correlation between PLGF and S/D, PLGF and PI, PLGF and RI (P<0.01). Spearman correlation coefficient respectively were-0.761,-0.617,-0.586.Conclusions:1. Preeclampsia group serum PLGF level is lower than the normal pregnant women, and severe preeclampsia group serum PLGF level is lower than mild preeclampsia group. The results suggest that PLGF may participate in the occurrence and the development of preeclampsia. What’s more, the level of PLGF correlates with the degree of severity of preeclampsia. The lower the level of PLGF, the more serious the disease.2. Preeclampsia group umbilical artery S/D, PI, RI values are lower than the normal pregnant women, and the values of umbilical artery S/D, PI, RI respectively correlate with the degree of severity of preeclampsia. The result suggest that preeclampsia umbilical artery blood flow resistance increased, and the risk of fetal distress increased which need paid more attention and to strengthen the monitoring.3. Serum level of PLGF and umbilical artery S/D, PI, RI values showed a negative correlation respectively in preeclampsia, which suggest that PLGF level is related to the change of placental vascular resistance. PLGF may involved in the pathogenesis of preeclampsia by affecting the recasting of uterine spiral arteries and by affecting the function of vascular endothelial cell. Combining PLGF and umbilical artery blood flow index may provide a better reference for the evaluation of fetal intrauterine condition and the prediction of adverse outcome of perinatal infants.