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School of Diagnosis|The clinical value of placental growth factor in the early diagnosis of preeclampsia

School of Diagnosis|The clinical value of placental growth factor in the early diagnosis of preeclampsia

(Summary description)

School of Diagnosis|The clinical value of placental growth factor in the early diagnosis of preeclampsia

(Summary description)


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  Significance of early diagnosis of preeclampsia  


Preeclampsia (preeclampsia, PE) is a common serious complication in pregnant women. It refers to abnormal symptoms such as hypertension and proteinuria after 20 weeks of pregnancy, or accompanied by impaired maternal organ function and fetal complications. The incidence of PE in my country is 5% to 7%, causing about 15% of premature fetuses and 42% of maternal deaths, which seriously threatens the life and health of pregnant women and fetuses. At present, the diagnosis of PE is mainly based on the patient’s symptoms, blood pressure, urine protein and other indicators, but these indicators are relatively low specific and sensitive. When the patient is diagnosed with PE, the disease often progresses to an advanced stage, and the intervention space is small and difficult to control. Condition. In addition, there is no effective treatment for PE. The only treatment is termination of pregnancy. However, early termination of pregnancy will increase the probability of premature babies and is not conducive to the health of newborns. Therefore, screening for early diagnosis markers of PE, early intervention and monitoring of high-risk pregnant women with PE, prevention and treatment of PE, and improvement of pregnancy outcome are of great significance



  The content of placental growth factor changes with the course of pregnancy


Placental growth factor is mainly secreted by trophoblast cells. It is a kind of vascular endothelial growth factor. It is mainly distributed in the placenta. It promotes the proliferation and differentiation of trophoblast cells and vascular endothelial cells, promotes the stability and formation of placental blood vessels, and inhibits the apoptosis of trophoblasts and vascular endothelial cells. Death, promote the formation of placental vascular network and maintain normal blood perfusion of the placenta. Studies have shown that PlGF is abundantly expressed in normal pregnant women, but its content in plasma of non-pregnant women and men is extremely low or even undetectable. During normal pregnancy, the level of PlGF is different at different stages, and its change curve is bell-shaped. It is low in the early pregnancy, gradually increasing at 15 weeks, reaching a peak at 28-30 weeks, and then gradually decreasing as the gestational week increases. For PE patients, the level of PlGF in early pregnancy is not much different from that of normal pregnant women. After 20 weeks, it is significantly lower than that of normal pregnant women, and the serum PlGF level of PE pregnant women has gradually decreased in less than 30 weeks.。


  The clinical application value of PlGF expression level in the early diagnosis of PE  


   The 105 normal pregnant women (control group), 69 patients with mild PE (mild group) and 54 patients with severe PE (severe group) admitted to Tianjin Third Central Hospital were the subjects of study. Fluorescence immunoassay was used to determine plasma To explore the clinical application value of PlGF expression level in the early diagnosis of PE.


Analysis of Plasma PlGF Levels Comparison of Plasma Plasma Levels among the three groups of pregnant women showed that the differences were statistically significant (P<0.05). Compared with the normal control group, the plasma PlGF levels in the mild group and the severe group were lower, and the serum PlGF levels in the severe group were lower than those in the mild group. The difference was statistically significant (P<0.05), see Table 2.



   The predictive value of peripheral blood PlGF for PE Combining mild PE group and severe PE into the PE group, using plasma PlGF to predict the onset of PE, the area under the ROC curve (AUC) is 0.962 (95%CI: 0.921~1.000, P< 0.05), the maximum value of the Youden index is 0.907, and the corresponding plasma PLGF value is 47.5pg/ml, the specificity is 0.907, and the sensitivity is 0.900, as shown in Figure 1.。




In recent years, there have been more and more studies on the impact of PlGF on hypertension in pregnancy. Many scholars at home and abroad have also focused their attention on this, and believe that PlGF is of great significance in the diagnosis of PE. Currently. PlGF is commonly used clinically to guide the diagnosis, monitoring and treatment of PE. The results of this study showed that the differences in serum PlGF levels between the three groups were statistically significant. The peripheral plasma PlGF levels of the control group were higher than the mild and severe groups, and the mild group was higher than the severe group. Wu Xueqin et al. used enzyme-linked immunosorbent assay (ELISA) to detect the level of PIGF in the serum of PE patients and normal pregnant women and found the same result. And another study showed that the level of PLGF in the placental tissue of PE patients was significantly lower than that of healthy women. Foreign scholars also found the same results, which proves the results of this study from another aspect. This shows that PlGF reflects the severity of PE to a certain level, and early screening of PlGF has certain significance for early diagnosis of PE. This experiment further uses ROC curve technology to evaluate the application value of PlGF in the early diagnosis of PE. The results found that ROC predicts the AUC of PE to be 0.962 (95%CI: 0.921~1.000, P <0.05), and the cutoff value is 47.5pg/ml The sensitivity and specificity at time were 0.900 and 0.907, respectively, indicating that serum PIGF has a higher predictive value.


In summary, the level of PlGF in the peripheral blood of PE patients is significantly reduced, and the level of PlGF is negatively correlated with the severity of the disease. PlGF may be used as one of the methods for early screening of PE patients to prevent and control PE and provide help for the safety of mothers and babies. However, the existing clinical evidence is not enough to support the use of PlGF in the early diagnosis of PE. Therefore, a combination of maternal factors and multiple indicators are needed to support the results of this study, so as to better guide clinicians in the early diagnosis of PE and early detection of patients. , Early treatment to ensure the safety of mothers and babies.


  Healthy women and children Aucheer in action


Ningbo Aocheng focuses on providing reliable, fast and convenient in vitro diagnostic reagents from early disease detection, diagnosis, prevention to detection, and is committed to providing professional maternal and child health clinical diagnosis solutions. With Aucheer PlGF detection reagents, it will create A new era of preeclampsia risk assessment and management



Original source

Source: Jiang Fengli, Ma Yanan, Wu Li. The clinical value of placental growth factor in the early diagnosis of preeclampsia[J], Medical Information,2019,32(16):160-162


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