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sFlt-1∶PlGF比值在疑似先兆子痫女性中的预测价值
Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia


Harald Zeisler ... 其他 • 2016.01.07

摘要


背景

先兆子痫临床发作前,孕妇体内可溶性fms样酪氨酸激酶-1(sFlt-1)与胎盘生长因子(PlGF)的比值升高,但这一比值在疑似先兆子痫女性中的预测价值尚不清楚。

 

方法

我们开展了一项前瞻性、多中心、观察性研究,在疑似先兆子痫的单胎妊娠女性(妊娠24周0日至36周6日)中,推导并验证血清sFlt-1∶PlGF比值,该比值可预测短期内是否会出现先兆子痫。主要目的是评估低sFlt-1∶PlGF比值(等于或低于推导得出的临界值)是否预示着初次就诊后1周内不会发生先兆子痫,而较高比值(高于临界值)是否预示着4周内将发生先兆子痫。

 

结果

在开发队列中(500名女性),我们确定sFlt-1∶PlGF比值临界值38具有重要的预测价值。在另外550名女性中进行的后续验证研究中,sFlt-1∶PlGF比值为38或更低的阴性预测值(即在随后1周内不会出现先兆子痫)为99.3%(95%置信区间[CI],97.9~99.9),敏感性为80%(95% CI,51.9~95.7),特异性为78.3%(95% CI,74.6~ 81.7)。对于4周内诊断先兆子痫,sFlt-1∶PlGF比值高于38的阳性预测值为36.7%(95% CI,28.4~45.7),敏感性为66.2%(95% CI,54.0~77.0),特异性为83.1%(95% CI,79.4~86.3)。

 

结论

在临床上疑似先兆子痫的女性中,sFlt-1∶PlGF比值为38或更低可用于预测短期内不会发生先兆子痫(由罗氏诊断公司[Roche Diagnostics]资助)。





作者信息

Harald Zeisler, M.D., Elisa Llurba, M.D., Ph.D., Frederic Chantraine, M.D., Ph.D., Manu Vatish, M.B., Ch.B., D.Phil., Anne Cathrine Staff, M.D., Ph.D., Maria Sennström, M.D., Ph.D., Matts Olovsson, M.D., Ph.D., Shaun P. Brennecke, M.B., B.S., D.Phil., Holger Stepan, M.D., Deirdre Allegranza, B.A., Peter Dilba, M.Sc., Maria Schoedl, Ph.D., Martin Hund, Ph.D., and Stefan Verlohren, M.D., Ph.D.
From the Department of Obstetrics and Gynecology, Medical University Vienna, Vienna (H.Z.); the Department of Obstetrics, Maternal–Fetal Medicine Unit, Hospital Universitari Vall d’Hebron, Barcelona, and the Maternal and Child Health and Development Network, Instituto de Salud Carlos III, Madrid (E.L.); the Department of Obstetrics and Gynecology, University of Liege, Liege, Belgium (F.C.); Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom (M.V.); the Departments of Gynecology and Obstetrics, Oslo University Hospital, and University of Oslo, Oslo (A.C.S.); the Department of Women’s and Children’s Health, Karolinska University Hospital, and Karolinska Institute, Stockholm (M. Sennström), and the Department of Women’s and Children’s Health, Uppsala University, Uppsala (M.O.) — both in Sweden; Pregnancy Research Centre, Department of Perinatal Medicine, Royal Women’s Hospital and Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, VIC, Australia (S.P.B.); the Department of Obstetrics, University of Leipzig, Leipzig (H.S.), Roche Diagnostics, Penzberg (P.D., M. Schoedl), and the Department of Obstetrics, Campus Virchow–Klinikum Charité, Berlin (S.V.) — all in Germany; and Roche Diagnostics International, Rotkreuz, Switzerland (D.A., M.H.). Address reprint requests to Dr. Verlohren at the Department of Obstetrics, Campus Virchow–Klinikum Charité, Augustenburger Pl. 1, D-13353 Berlin, Germany, or at stefan.verlohren@charite.de.

 

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