Expression And Predictive Value Of Corin And Vascular Endothelial Factor In Hypertensive Disorder Complicating Pregnancy

Objective: The present project is to measure the maternal serum levels of corin,vascular endothelial growth factor(VEGF),placenta growth factor(PLGF)and soluble vascular endothelial growth factor receptor 1(sFlt-1)in pregnant women with different gestational age,then to explore the changes of these factors in HDCP patients and normal pregnant women and their relationship with the development of HDCP.The aim of the study is to investigate the diagnostic value about hypertensive disorders complicating pregnancy(HDCP)of these factores in maternal serum in the early and middle trimester pregnancy.Methods: There single pregnancy pregnant women were selected as study objects,who were received medical service in the Department of Gynecology and Obstetrics of Lanzhou University Second Hospital from Decdmber 2015 to September 2016.Detecting pregnant women with different trimesters pregnancy from the cross-sectional study.There pregnant women were divided into two groups according to the pregnancy outcome in every trimester pregnancy.24 cases were selected who developed HDCP in the first trimester pregnancy(10 to 14 weeks)and24 healthy pregnant women were selected as their normal control during the contemporaneous period.55 cases were selected who developed HDCP in the second trimester pregnancy(16 to 24weeks)and 55 healthy pregnant women were selected as their normal control during the contemporaneous period.23 cases were selected who were HDCP in the third trimester pregnancy and 23 healthy pregnant women were selected as their normal control during the contemporaneous period.The serum levels of corin,VEGF,PLGF and sFlt-1 were measured by ELISA.The differences between the above factors were analyzed by statistical method.Logistic regression and ROC curve were used to evaluate the effects of different factors predict the value of HDCP in the early and middle trimester pregnancy.Results:1.In the first trimester pregnancy,the serum level of corin、VEGF and PLGF of the HDCPgroup were lower than the normal pregnancy control group,there differences were statistically significant,P<0.05,but the serum level of s Flt-1 and sFlt-1/PLGF ratio of the HDCP group were higher than the normal pregnancy control group,there differences were statistically significant,P<0.05.2.In the middle trimester pregnancy,the serum level of VEGF and PLGFof the HDCP group were lower than the normal pregnancy control group,there differences were statistically significant,P<0.05;but the serum level of corin、sFlt-1 and sFlt-1/PLGF ratio of the HDCP group were higher than the normal pregnancy control group,there differences were statistically significant,P<0.05.3.In the third trimester pregnancy,the serum level of VEGF and PLGFof the HDCP group were lower than the normal pregnancy control group,there differences were statistically significant,P<0.05;but the serum level of corin、sFlt-1 and sFlt-1/PLGF ratio of the HDCP group were higher than the normal pregnancy control group,there differences were statistically significant,P<0.05.4.The logistic regression and ROC curve were used to evaluate the serum levels of corin,VEGF,PLGF,sFlt-1 and sFlt-1/PLGF in the early and middle trimester pregnancy.The results showed that each individual had predictive value for HDCP.In the early trimester pregnancy,the area under curve of the combination predicted probability PRE of corin,VEGF,PLGF,sFlt-1was 0.851 and the Youden index was 0.625,and the corresponding sensitivity was 83.3% and the specificity was 79.2%,which was significantly higher than that of individual test index and sFlt-1/PLGF.In the middle trimester pregnancy,the area under curve of the combination predicted probability PRE of corin,VEGF,PLGF,sFlt-1 was 0.927 and the Youden index was0.691,and the corresponding sensitivity was 87.3% and the specificity was 82.8%,which was significantly higher than that of individual test index and s Flt-1/PLGF.Conclusion:1.The maternal serum levels of corin,VEGF,PLGF and sFlt-1 were differences between the HDCP group and the control group in the first、middle and third trimester pregnancy,indicating that the above factors and the occurrence and development of HDCP.2.We found that there are predictable value for HDCP of the measurement the maternal serum levels of corin,VEGF,PLGF and sFlt-1 in the early and middle trimester pregnancy,but the combination of there factors have higher sensitivity and specificity,the results are more reliable and predict higher value.