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目的 探讨促血管生成因子(PIGF)、可溶性血管内皮生长因子受体-1(sFlt-1)、25-羟基维生D的活化形式1,25二羟基维生D、血管性假血友病因子(vWF)和P-选择素与子痫前期的相关性.方法 前瞻性选择2013年1月至2013年12月9～12孕周准备在复旦大学附属妇产科医院完成产检和分娩的2029例孕妇作为研究对象,随访妊娠结局,将发生子痫前期者纳入病例组,共63例,其中发生轻度子痫前期45例(轻度子痫前期组),重度子痫前期18例(重度子痫前期组),选取上述2029例中无妊娠合并症或并发症的正常孕妇252例为对照组.检测血清sFlt-1、PIGF、25-羟基维生D、vWF以及P-选择素水平,并比较其在轻度、重度子痫前期以及正常孕妇之间的差异,分析上述血清指标对子痫前期发生的预测价值.结果 重度子痫前期组血清sFlt-1水平显著高于轻度子痫前期组和对照组(1467.3±342.3 pg/ml,1143.3±214.3 pg/ml和724.3±125.3 pg/ml,F=5.453,P<0.001).重度子痫前期组血清PIGF水平显著低于轻度子痫前期组和对照组(25.64±8.43 pg/ml,39.42±9.34 pg/ml和50.32±10.31 pg/ml,F=6.342,P<0.001).重度子痫前期组血清25-羟基维生D水平显著低于轻度子痫前期组和对照组(20.31±6.5 ng/ml,34.52±7.31 ng/ml和40.32±7.34 ng/ml,P=0.025).重度子痫前期组血清P-选择素水平显著高于轻度子痫前期组和对照组(145.4±15.4 ng/ml,100.4±14.5 ng/ml和89.4±12.1 ng/ml,F=5.212,P=0.012).三组之间血清vWF水平差异无统计学意义(P=0.342).逐步Logistic回归发现血清sFlt-1(OR=3.485,95％CI:2.342～7.126)、PIGF(OR=0.734,95％CI:0.545～0.891)水平对子痫前期具有较好的预测价值.结论 妊娠早期sFlt-1、PIGF水平在子痫前期的发生中最具有预测价值,值得临床参考应用.“,”Objective To investigate the correlation between sFlt - 1,PIGF,25 - hydroxyvitamin D,vWF and P - selectin in preeclamp-sia. Methods A total of 2029 pregnant women who completed childbirth examination and delivery in Fudan University affiliated Obstetrics and Gynecology Hospital were included in the study about 9 to 12 weeks of gestation from January 2013 to December 2013. There were 63 patients with preeclampsia froom pregnancy outcomes,in which 45 were mild preeclampsia and 18 were severe preeclampsia. From the above 2029 cases,252 cases of normal pregnant women with no pregnancy complications were selected as control group. Serum levels of sFlt - 1,PIGF,25 - hydroxyvita-min D,vWF and P - selectin were measured and their differences in mild to severe preeclampsia and normal pregnant women were compared. The serum levels of these indicators were analyzed for preeclampsia. Results Serum levels of sFlt - 1 in severe preeclampsia group were significantly higher than those in mild preeclampsia group and control group (1467. 3 ± 342. 3 pg/ ml,1143. 3 ± 214. 3 pg/ ml and 724. 3 ± 125. 3 pg/ ml,F =5. 453,P < 0. 001). Serum PIGF levels in severe preeclampsia group were significantly lower than those in mild preeclampsia group and control group (25. 64 ± 8. 43 pg/ ml,39. 42 ± 9. 34 pg/ ml and 50. 32 ± 10. 31 pg/ ml,F = 6. 342,P < 0. 001). Serum 25 - hydroxyvitamin D levels in severe preeclampsia were significantly lower than those in mild preeclampsia and controls (20. 31 ± 6. 5 ng/ ml,34. 52 ± 7. 31 ng/ ml and 40. 32 ± 7. 34 ng/ ml,P = 0. 025). Serum P - selectin levels in severe preeclampsia group were significantly higher than those in mild preeclampsia group and control group (145. 4 ± 15. 4 ng/ ml,100. 4 ± 14. 5 ng/ ml and 89. 4 ± 12. 1 ng/ ml,F = 5. 212,P = 0. 012). There was no significant differ-ence in serum vWF levels among the three groups (P = 0. 342). The level of serum sFlt - 1 (OR = 3. 485,95％ CI:2. 342 - 7. 126)and PIGF (OR = 0. 734,95％ CI:0. 545 - 0. 891)were found to be of good predictive value. Conclusion The sFlt - 1 and PIGF levels in early pregnancy are the most predictive value in the occurrence of preeclampsia,which can be considered as clinical reference.