【摘要】 目的探讨可溶性fms样酪氨酸激酶1(sFlt-1)与胎盘生长因子(PlGF)的比率对疑似子痫前期妇女的预测价值。方法我们进行了一项前瞻性研究,以验证对于疑似子痫前期的孕妇(20周0天至36周6天妊娠),血清sFlt-1∶PlGF比率(等于或低于截断值)预测在1周内无子痫前期发生,以及高比率(高于截断值)可预测4周发生内子痫前期。结果在既往研究中,确定了sFlt-1∶PlGF比率截断值38具有重要的预测价值,对于本验证研究中的550名孕妇,sFlt-1∶PlGF比率为38或更低,具有阴性预测值(即随后一周不发生子痫前期)为99.3%(95%CI,97.9～99.9),灵敏度为80.0%(95%CI,51.9～95.7)和特异性为78.3%(95%CI,74.6～81.7)。sFlt-1∶PlGF的比率超过38的阳性预测值(在4周内诊断为子痫前期)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)。结论对于临床上疑似子痫前期孕妇,sFlt-1∶PlGF比率为38或更低可预测在短期内不会发生子痫前期。更多还原

【Abstract】 Objective To investigate the predictive value of soluble fms-like tyrosine kinase 1(sFlt-1) and placental growth factor(PlGF) ratio in women with suspected preeclampsia. Methods We performed a prospective, multicenter, observational study to prove in the short term in women with singleton pregnancies,whether low sFlt-1∶PlGF ratios(at or below a derived cutoff) predict the absence of preeclampsia within 1 week and whether high ratios(above the cutoff) predict the presence of preeclampsia within 4 weeks. Results In a subsequent validation study among an additional 550 women, an sFlt-1∶PlGF ratio of 38 or lower had a negative predictive value(i.e., no preeclampsia in the subsequent week) of 99.3%(95% confidence interval [CI], 97.9 to 99.9), with 80.0% sensitivity(95% CI, 51.9 to 95.7) and 78.3% specificity(95% CI, 74.6 to 81.7). The positive predictive value of an sFlt-1∶PlGF ratio above 38 for a diagnosis of preeclampsia within 4 weeks was 36.7%(95% CI, 28.4 to 45.7), with 66.2% sensitivity(95% CI, 54.0 to 77.0) and 83.1% specificity(95% CI, 79.4 to 86.3). Conclusion An sFlt-1∶PlGF ratio of 38 or lower can be used to predict the short-term absence of preeclampsia in women in whom the syndrome is suspected clinically.更多还原