Study On The Correlation Between The Change Of SFlt-1/PLGF Ratio In Serum And Severe Preeclampsia And Its Predictive Value

Objective: Exploring the correlation between the ratio of soluble vascular endothelial growth factor receptor 1(s Flt-1)and placental growth factor(PLGF)and the occurrence of severe preeclampsia and its predictive value,to provide reference for the diagnosis and prediction of severe preeclampsia.Methods: Collected 56 cases serum samples which were from pregnant women diagnosed as severe preeclampsia as a case group,24 cases serum samples of normal pregnant women as a control group and 32 cases serum samples of pregnant women as a validation group.Application of electrochemical luminescence technique to detect the s Flt-1 and PLGF levels of the 102 samples and then computing s Flt-1 / PLGF ratio.100 samples were successfully detected,2 samples were unable to detect because of hemolysis.Mann-Whitney U test was used to compare the difference between mean � standard deviation(sx�)of three indexes(s Flt-1,PLGF,s Flt-1/PLGE)in case group and control group,to analyze their correlations with severe preeclampsia.The cutoff values of s Flt-1,PLGF and s Flt-1/PLGE were determined by ROC curve.The samples from the validation group were screened for high risk and low risk,compared with the final diagnosis results,the predictive value of s Flt-1,PLGF and s Flt-1/PLGE for severe preeclampsia was explored.Results: There was no significant difference in the general data(single fetus,age,gestational week,weight,BMI)between the case group and the control group(P >0.05).Serum level of s Flt-1 in the case group was significantly higher than that in the control group[11957.19 � 7966.17(mg/ml)vs 2187.94 � 851.40(mg/ml),P<0.001],the level of PLGF was significantly lower than that of the control group [103.69�83.99(mg/ml)vs373.49�189.98(mg/ml),P<0.001],and the ratio of s Flt-1/PLGE was significantly higher than that of the control group [275.82�352.27(mg/ml)vs 6.64�3.15(mg/ml),P<0.001].Used the ROC curve to determine the cutoff value of s Flt-1 was 2893.50(pg/ml)(AUC=0.946,sensitivity:92.6%,specificity:87.5%),the cutoff value of PLGF was 190.90(pg/ml)(AUC=0.928,sensitivit:85.20%,specificity:95.80%)and the cutoff value of s Flt-1/PLGE was 18.35(AUC=0.978,sensitivit:92.6%,specificity:100%).The use of s Flt-1 index to predict the specimens of validation group,the sensitivity was 80%,specificity was 85.19%,the positive predictive value was 50%,the coincidence rate was84.38%;the use of PLGF to predict the specimens of validation group,the sensitivity was40%,specificity was 88.89%,the positive predictive value was 40%,the coincidence rate was 81.25%;using s Flt-1/PLGF,sensitivity was 80%,the specificity was 100%,the positive predictive value was 100%,the coincidence rate was 96.88%.Conclusions: The ratio of soluble vascular endothelial growth factor receptor 1(s Flt-1)and placental growth factor(PLGF)in pregnant women with severe preeclampsia is significantly higher than that in healthy pregnant women.There is a significant correlation between the change of s Flt-1/PLGF and the occurrence of severe preeclampsia.It has a certain value in predicting the occurrence of severe preeclampsia,and its prediction effect is much better than that of s Flt-1 and PLGF alone.