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首页> 外文期刊>American Journal of Obstetrics and Gynecology >Evidence of an imbalance of angiogenic/antiangiogenic factors in massive perivillous fibrin deposition (maternal floor infarction): A placental lesion associated with recurrent miscarriage and fetal death
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Evidence of an imbalance of angiogenic/antiangiogenic factors in massive perivillous fibrin deposition (maternal floor infarction): A placental lesion associated with recurrent miscarriage and fetal death

机译：大量周生纤维蛋白沉积（产妇底板梗死）中血管生成/抗血管生成因子失衡的证据：与反复流产和胎儿死亡相关的胎盘病变

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Objective: Massive perivillous fibrin deposition (MPFD) is associated with serious complications of pregnancy including recurrent spontaneous abortion, fetal growth restriction, and fetal demise. The aim of this study was to determine whether maternal plasma concentrations of angiogenic/antiangiogenic factors in MPFD differ from those of uncomplicated pregnancies. Study Design: This retrospective longitudinal case-control study included MPFD cases (n = 10) and control patients (n = 175) with uncomplicated pregnancies who were enrolled in a longitudinal study and delivered at term. Serial plasma concentrations of placental growth factor (PlGF), soluble endoglin (sEng), and soluble vascular endothelial growth factor receptor (sVEGFR)-1 and -2 were determined by an enzyme-linked immunosorbent assay (cases, n = 28 samples; controls, n = 723 samples). Individual analyte concentrations were averaged across gestational age at specimen collection intervals. Linear mixed models were used to test for differences in log-transformed mean analyte concentrations both overall and as a function of time. Results: The following results were found: (1) patients with MPFD had a lower mean plasma PlGF concentration (P =.03) and higher mean plasma concentrations of sVEGFR-1 and sEng (both P <.01) than controls, adjusted for potential confounders; (2) the mean plasma concentration of PlGF differed further among cases and controls as a function of gestational age interval (P <.0001); however, mean sVEGFR-1 and sEng group differences as a function of gestational age interval approached but did not reach significance (P =.09 and P =.11, respectively); (3) patients with MPFD had lower mean plasma concentrations of PlGF/sVEGFR-1 (P <.0001) and PlGF/sEng (P <.001): both of these relationships differed further as a function of gestational age interval (both P <.0001); and (4) differences in mean sVEGFR-1, sEng, and the ratios of PlGF to sVEGFR-1 and PlGF to sEng were observed before 20 weeks of gestation. Conclusion: An imbalance of angiogenic/antiangiogenic factors is present in patients with MPFD prior to the diagnosis. We propose that these changes participate in the mechanisms responsible for adverse pregnancy outcomes in patients with MPFD.
机译：目的：大量的周围性纤维蛋白沉积（MPFD）与严重的妊娠并发症相关，包括反复自然流产，胎儿生长受限和胎儿死亡。这项研究的目的是确定母婴血浆中MPFD中血管生成/抗血管生成因子的浓度是否与单纯妊娠的血浆浓度不同。研究设计：这项回顾性纵向病例对照研究包括MPFD病例（n = 10）和对照患者（n = 175），这些患者均纳入了单纯妊娠，并参加了纵向研究并在足月分娩。通过酶联免疫吸附测定法测定胎盘生长因子（PlGF），可溶性内皮糖蛋白（sEng）和可溶性血管内皮生长因子受体（sVEGFR）-1和-2的系列血浆浓度（病例，n = 28;对照组） ，n = 723个样本）。在样本采集间隔内，各个胎龄的平均分析物浓度取平均值。线性混合模型用于测试整体和时间的对数转换后的平均分析物浓度的差异。结果：发现以下结果：（1）MPFD患者的平均血浆PlGF浓度较低（P = .03），而sVEGFR-1和sEng的平均血浆浓度较高（均为P <.01），均已校正。潜在的混杂因素; （2）PlGF的平均血浆浓度在不同病例和对照之间随胎龄间隔而变化（P <.0001）;然而，作为胎龄间隔函数的sVEGFR-1和sEng组的平均差异已接近但没有达到显着性（分别为P = .09和P = .11）; （3）MPFD患者的血浆PlGF / sVEGFR-1（P <.0001）和PlGF / sEng（P <.001）的平均血浆浓度较低：这两种关系随胎龄间隔的变化而进一步不同（均P <.0001）; （4）在妊娠20周之前观察到平均sVEGFR-1，sEng的差异，以及PlGF与sVEGFR-1的比率以及PlGF与sEng的比率。结论：MPFD患者在诊断之前存在血管生成/抗血管生成因子的失衡。我们建议这些变化参与MPFD患者不良妊娠结局的机制。

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