Study on the Relationship between Serum VEGF,sFlt-1 and IL-4 Levels and the Severity and Prognosis of Patients with Hypertensive Disorders in Pregnancy
Objective:To investigate the relationship between serum vascular endothelial growth factor(VEGF),soluble Fms-like tyrosine kinase-1(sFlt-1)and interleukin-4(IL-4)levels and the classification and pregnancy outcome of patients with hypertensive disorders of pregnancy(HDP).Methods:A total of 204 patients with HDP admitted to our hospital from July 2019 to January 2021(HDP group)were selected and divided into pregnancy induced hypertension group(n=88),pre-eclampsia group(n=66),and eclampsia group(n=50)according to the guideline classification,and divided into poor outcome group and good outcome group according to the pregnancy outcome,and another 100 healthy pregnant women who delivered in our hospital during the same period were selected as the control group.Univariate and multivariate Logistic regression and receiver working characteristics(ROC)curves were used to analyze the influence factors of adverse pregnancy outcomes in HDP patients and the predictive value of serum VEGF,sFlt-1 and IL-4 levels.Results:Compared with the control group,the levels of serum VEGF and IL-4 in the HDP group decreased,the level of sFlt-1 increased(P＜0.05).Serum VEGF and IL-4 levels decreased and sFlt-1 levels increased sequentially in the gestational hypertension,preeclampsia and eclampsia groups(P＜0.05).The incidence of adverse pregnancy outcomes in 204 HDP patients was 29.90％(61/204).Single factor analysis showed,poor pregnancy outcomes were associated with age,classification of disease,SBP,DBP,urinary protein,VEGF,sFlt-1,and IL-4(P＜0.05).Multifactorial logistic regression analysis showed that eclampsia and elevated sFlt-1 were independent risk factors for poor pregnancy outcome in HDP patients,and elevated VEGF and IL-4 were independent protective factors(P＜0.05).The area under the curve(AUC)for predicting adverse pregnancy outcomes in HDP patients with serum VEGF,sFlt-1,and IL-4 levels alone and in combination were 0.766,0.774,0.770 and 0.905,respectively and the AUC for poor pregnancy outcomes in HDP patients of the combination of VEGF,sFlt-1,and IL-4 predicts was the highest.Conclusions:Decreased serum VEGF and IL-4 levels and increased sFlt-1 levels in HDP patients are associated with HDP classification and poor pregnancy outcome,and the combination of VEGF,sFlt-1,and IL-4 has a high predictive value for poor pregnancy outcome in HDP patients.
Hypertensive disorders in pregnancyVEGFsFlt-1IL-4Prognosis
NETL
NSTL
万方数据
维普
