Abstract: Objective To explore the value of combined detection of soluble FMS like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) in evaluating the severity and prognosis of acute fatty liver during pregnancy (AFLP).Methods 35 AFLP patients admitted from January 2018 to July 2021 were included in the observation group. According to the level of prothrombin activity (PTA), they were divided into mild group and severe group, and were divided into easy to cure group and difficult to cure group according to the cure time. Thirty-five healthy pregnant women were included in the control group. The serum levels of sFlt-1, PlGF, postprandial blood glucose (PBG), albumin (Alb), total bilirubin (TBil), prothrombin time (PT) and creatinine (Cr) in the observation group and the control group were compared. The levels of serum sFlt-1 and PlGF in subgroups with different severity of disease and different cure time were compared. The correlation between serum sFlt-1 and PlGF levels and PBG, Alb, TBil, PT and Cr levels was compared, and the diagnostic efficacy of sFlt-1 and PlGF levels alone and combined detection was analyzed by regression analysis.Results The serum sFlt-1 level in the observation group (3829.57±506.41 pg/mL) was higher than that in the control group (516.48±87.25 pg/mL), and the serum PlGF level (152.64±35.17 pg/mL) was lower than that in the control group (375.62±74.38 pg/mL). The difference was statistically significant (t=187.258, 16.492, P<0.05). The levels of TBil, Cr and PT in observation group were significantly higher than those in control group, while the levels of PBG and Alb were lower than those in control groups (P<0.05). In the observation group, the serum sFlt-1 levels of severe and difficult to cure groups (5024.86±638.57 pg/mL, 4659.27±471.83 pg/mL) were higher than those of mild and easy to cure groups (2908.59±304.80 pg/mL, 3260.85±369.42 pg/mL), respectively, and the difference was statistically significant (t=25.385, 19.473, P<0.05). PlGF levels (98.38±27.35 pg/mL, 107.34±29.68 pg/mL) were lower than those of mild and difficult to cure groups (187.45±48.61 pg/mL, 172.56±45.19 pg/mL), and the difference was statistically significant (t=19.276, 14.725, P<0.05). Pearson analysis showed that the serum sFlt-1 level of AFLP patients was negatively correlated with PBG and Alb levels, but positively correlated with TBil, Cr and PT levels (P<0.05). Serum PlGF levels were positively correlated with PBG and Alb levels, but negatively correlated with TBil, Cr and PT levels (P<0.05). Receiver operating characteristic (ROC) curve showed that the area under curve (AUC) of sFlt-1, PlGF and combined detection for AFLP diagnosis were 0.925, 0.903 and 0.976, respectively, indicating that combined detection was significantly more efficient than any single detection (P<0.05).Conclusion Serum sFlt-1 and PlGF levels have higher clinical value in evaluating the severity and prognosis of AFLP patients, and the combined detection is more effective.

Key words: Acute fatty liver in pregnancy, sFlt-1, PlGF, Prognosis