Correlation Analysis Of Serum SFlt-1、VEGF,sFlt-1/VEGF Levels And Hypertensive Disorder Complicating Pregnancy

Objective:The levels of soluble fms-like tyrosine kinase-1(sFlt-1),vascular endothelial growth factor(VEGF)and sFlt-1/VEGF ratio in serum of patients with hypertensive disorder complicating pregnancy were studied.To investigate the correlation between sFlt-1,VEGF,sFlt-1/VEGF levels and hypertensive disorders of pregnancy(HDP),and to provide reference for judging the severity of HDP.Methods:The clinical data of pregnant women who underwent prenatal examination in our hospital from November 01,2021 to October 31,2022 were summarized and the appropriate samples were selected for retrospective analysis.This study was divided into normal pregnancy group and HDP group.According to the guidelines,the HDP group was divided into gestational hypertension group and preeclampsia group according to the severity of the disease to analyze the correlation between the above indexes and the severity of HDP.Among them,70 healthy pregnant women were selected from the summarized clinical data in the normal pregnancy group,and 159 hypertensive patients who came to our hospital for prenatal examination in the same period were selected in the HDP group,including 82 cases in the gestational hypertension group and 77 cases in the preeclampsia group.The sFlt-1 and VEGF factors in each group were quantitatively determined by direct chemiluminescence method,and its statiscal differences were analyzed by SPSS 26.0 statistical software.Binary logistic regression was used to analyze the influence of the above factors and their ratios on HDP.The best diagnostic cut-off points of sFlt-1,VEGF and sFlt-1/VEGF made by the ROC curve,and the diagnostic value of HDP was judged by combining sensitivity and specificity.Results:1.Comparison of general information on pregnant womenThe remaining 48 cases of normal pregnancy group and 48 cases of HDP group were matched by PSM method,and the data of the two groups were analyzed,the difference in age,weeks of pregnancy and duration of pregnancy is not statistical(P>0.05)in the normal pregnancy group and in pregnant women in the HDP group,the initial data are the same and comparable.2.Comparison of sFlt-1,VEGF levels and sFlt-1/VEGF ratio in serum between the two groupsCompared with the normal pregnancy group,the sFlt-1 level and sFlt-1/VEGF ratio in serum increased in the HDP group,and the statistical differences were existed between the two groups(P<0.001).The VEGF level in serum decreased,and it had statistical difference(P<0.001).3.Correlation analysis of sFlt-1,VEGF and sFlt-1/VEGF levels in serum in patients with different severity of HDP.Spearman correlation analysis showed that different degrees of HDP had different correlations with the above serological indicators.The sFlt-1concentration had positive correlation with the severity of HDP in serum,the correlation coefficient was 0.746.The serum VEGF concentration had negative correlation with the severity of HDP,the correlation coefficient was-0.708.The sFlt-1/VEGF concentration had positive correlation with the severity of HDP in serum,the correlation coefficient was 0.764,and all of their difference had statistical significence(P<0.001).The absolute value of the correlation coefficient greater than 0.7 indicated a strong correlation between the two.4.Binary multivariate Logistic regression analysis results of HDPThe levels of sFlt-1,VEGF and sFlt-1/VEGF in serum of HDP patients have close relation with the severity of the disease.Therefore,the levels of sFlt-1,VEGF and sFlt-1/VEGF were combined by us to construct a binary multivariate Logistic regression equation to determine the progression of HDP patients.The results showed that the increase of sFlt-1 level,the decrease of VEGF level and the increase of sFlt-1/VEGF ratio had significant correlation with the development of HDP,all of which had statistical significance(P<0.001).5.The ROC curve was used to evaluate the diagnostic value of the detection index.ROC curve showed that the AUC values of sFlt-1,VEGF and sFlt-1/VEGF in the diagnosis of HDP were 0.888,0.895 and 0.905 in serum,respectively.The AUC value of sFlt-1/VEGF was the largest.ROC curve analysis showed that the cut-off values of sFlt-1,VEGF and sFlt-1/VEGF were4124pg/ml,44.19pg/ml and 74.95,respectively.The Youden index of sFlt-1/VEGF had the largest numerical value in combined detection,with a sensitivity of 89.6% and a specificity of 91.5%,which was significantly better than the diagnostic value of sFlt-1 and VEGF single detection.Conclusions:The sFlt-1,VEGF and sFlt-1/VEGF in serum are closely related to HDP.The increase of sFlt-1 level,sFlt-1/VEGF ratio in serum and the decrease of VEGF level can lead to or aggravate HDP.The sFlt-1 and sFlt-1/VEGF in serum are risk factors for HDP,and VEGF in serum is a protective factor for HDP.The ratio of sFlt-1/VEGF has high sensitivity and specificity in the diagnosis of HDP severity,and has important value in the diagnosis of HDP severity.It has higher accuracy than single index detection.