摘要
目的探讨妊娠早中期血清妊娠相关血浆蛋白A(PAPP-A)、甲胎蛋白(AFP)、雌三醇(u E3)在预测子痫前期中的价值。方法纳入单胎妊娠孕妇1 912例,其中正常孕妇1 843例(正常组),子痫前期孕妇69例(子痫前期组),子痫前期组分为重度子痫前期组24例及轻度子痫前期组45例。采用酶联免疫吸附法检测1 912例孕妇孕早期血清PAPP-A、人绒毛膜促性腺激素(β-HCG)及孕中期AFP、β-HCG和u E3水平。绘制受试者工作特征(ROC)曲线评价单个指标及联合预测子痫前期的价值。结果孕早期子痫前期组血清PAPP-A水平明显低于正常组(P<0.05),重度子痫前期组血清PAPP-A水平明显低于轻度子痫前期组(P<0.05),但孕早期子痫前期组与正常组、轻度子痫前期组与重度子痫前期组血清β-HCG水平分别比较,差异均无统计学意义(P>0.05);孕中期子痫前期组血清u E3、AFP水平均低于正常组(P<0.05),但两组血清β-HCG水平比较,差异无统计学意义(P>0.05),孕中期轻度子痫前期组血清β-HCG、u E3、AFP水平与重度子痫前期组比较,差异均无统计学意义(P>0.05);PAPP-A、u E3、AFP单项指标及其联合对子痫前期都有一定的预测价值(P<0.05),血清PAPP-A、u E3、AFP水平联合预测子痫前期的ROC曲线下面积最大,为0.782。结论子痫前期孕妇孕早期血清PAPP-A、孕中期AFP及u E3水平低于正常孕妇,血清PAPP-A、u E3、AFP水平单独或者3者联合均可预测子痫前期,而联合预测的价值较高,优于任何一个单独指标。
Objective To investigate the clinical value of serum pregnancy-associated plasma protein A （PAPP-A）, alpha-fetoprotein （AFP） ,and unconjugated estriol（uE3） for prediction of preeclampsia in the first and second trimester of pregnancy. Methods A total of 1 912 monocyesis women were enrolled,including 1 843 normal pregnant women （normal group） and 69 pregnant women with preeclampsia （ preeelampsia group ）. And the preeelampsia group was grouped into severe preeelampsia group （ n = 24 ） or mild preeelampsia group （ n = 45 ）. Serum PAPP-A and [3 human chorionie gonadotropin （[3-HCG） levels in the first trimester of pregnancy, and AFP, [3-HCG and uE3 levels in the second trimester of pregnancy were measured in 1 912 pregnant women using enzyme-linked immunosorbent assay. The values of single index and combined indices for predicting preeclampsia were analyzed using receiver operating characteristic （ROC） curve. Results In the first trimester of pregnancy,the serum PAPP-A level in the preeclampsia group was lower than that in the normal group（P 〈0.05 ） , and the serum PAPP-A level in the severe preeclampsia group was significantly lower than that in the mild preeclampsia group（ P 〈 0.05 ） , but there was no significant difference in the serum [3-HCG level between the preeelampsia group and the normal group ,or between the mild preeclampsia group and the severe preeclampsia group （P 〉 0.05 ）. In the second trimester of pregnancy, the serum uE3 and AFP levels in the preeclampsia group were lower than those in the normal group（ P 〈 0.05 ） ,but there was no significant difference in the serum [3-HCG level between the preeclampsia group and the normal group（P 〉 0.05 ）. In the second trimester of pregnancy,there were no significant differences in the serum [3-hCG, uE3, or AFP levels between the mild preeelampsia group and the severe preeclampsia group（ P 〉 0.05 ）. PAPP-A, uE3, AFP, and the combination of these indices obtained a certain value for predicting preeclampsia （ P 〈 0.05 ）. And the area under ROC curve of the combination of serum PAPP-A, uE3, and AFP for predicting preeclampsia was the largest （0.782）. Conclusion The serum PAPP-A level in the first trimester of pregnancy, AFP and uE3 level in the second trimester of pregnancy are lower in the pregnant women with preeelampsia compared to the normal pregnant women. Serum PAPP-A, uE3, AFP, and the combination of these indices can predict preeelampsia, but the combination obtains a higher value ,and is superior to any of the single index.
出处
《广西医学》
CAS
2016年第12期1688-1690,共3页
Guangxi Medical Journal
关键词
子痫前期
妊娠相关血浆蛋白A
甲胎蛋白
雌三醇
孕早期
孕中期
Preeclampsia, Pregnancy-associated plasma protein A,Alpha-fetoprotein , Unconjugated estriol, First trimester of pregnancy,Second trimester of pregnancy
