摘要
目的探讨子痫前期(PE)患者血清妊娠相关血浆蛋白A(PAPP-A)和同型半胱氨酸(Hcy)表达对妊娠结局的影响。方法选取2020年1月至2023年1月在我院进行产前检查与分娩的PE患者128例为研究对象,采用酶联免疫吸附法(ELISA)检测孕妇产前血清PAPP-A、Hcy表达水平。根据妊娠结局将患者分为结局良好组与结局不良组。采用Logistic回归分析PE患者不良妊娠结局的影响因素。通过受试者工作特征(ROC)曲线分析PE患者血清PAPP-A、Hcy表达水平对不良妊娠结局的预测效能。结果128例PE患者妊娠结局不良发生率为27.34%(35/128)。结局不良组患者血清PAPP-A水平较结局良好组下调(P<0.05),Hcy水平较结局良好组上调(P<0.05)。结局不良组患者分娩时孕周、血小板计数均少于结局良好组(P<0.05),而重度PE、早发型PE患者占比则高于结局良好组(P<0.05)。Logistic回归分析结果表明,重度PE、早发型PE、Hcy高表达均为PE患者妊娠结局不良的危险因素(P<0.05),血小板计数与PAPP-A高表达均为保护因素(P<0.05)。ROC分析结果表示,PE患者血清PAPP-A、Hcy水平联合预测不良妊娠结局的曲线下面积(AUC)为0.913,高于单独PAPP-A预测的AUC(Z=2.415,P=0.016)与单独Hcy预测的AUC(Z=2.416,P=0.016)。结论PE患者中妊娠结局不良者的Hcy水平上调,PAPP-A水平下调,二者均对PE患者妊娠结局具有预测价值,且二者联合预测的效能更佳。
Objective To investigate the impacts of serum pregnancy associated plasma protein A(PAPP-A)and homocysteine(Hcy)expression on pregnancy outcomes in patients with preeclampsia(PE).Methods A total of 128 PE patients who underwent prenatal examination and delivery in our hospital from January 2020 to January 2023 were collected as the research subjects,enzyme linked immunosorbent assay(ELISA)was applied to detect the expression levels of PAPP-A and Hcy in pregnant women's serum before delivery.According to pregnancy outcomes,patients were grouped into a good outcome group and a poor outcome group.Logistic regression was applied to analyze the influencing factors of adverse pregnancy outcomes in PE patients.ROC curve was applied to analyze the predictive efficacy of serum PAPP-A and Hcy expression levels in PE patients on adverse pregnancy outcomes.Results The incidence of adverse pregnancy outcomes in 128 PE patients was 27.34%(35/128).The serum PAPP-A level in poor outcome group was lower than that in the good outcomes group(P<0.05),while the Hcy level was higher than that in the good outcomes group(P<0.05).The gestational age at delivery and platelet count of patients in the poor outcome group were lower than those in the good outcome group(P<0.05),the proportions of patients with severe PE and early-onset PE were higher than those in the good outcomes group(P<0.05).The results of Logistic regression analysis showed that severe PE,early onset PE,and high expression of Hcy were all risk factors for poor pregnancy outcomes in PE patients(P<0.05),while platelet count and high expression of PAPP-A were protective factors(P<0.05).The ROC analysis results showed that the area under the curve(AUC)of the combined prediction of serum PAPP-A and Hcy levels in PE patients for adverse pregnancy outcomes was 0.913,which was higher than the AUC predicted by PAPP-A alone(Z=2.415,P=0.016)and the AUC predicted by Hcy alone(Z=2.416,P=0.016).Conclusion The Hcy level in patients with poor pregnancy outcomes is up-regulated,while PAPP-A level is down-regulated.Both have predictive value for pregnancy outcomes in PE patients,and the combined prediction of the two is more effective.
作者
陶甜甜
秦易楷
卢文
闫丽
Tao Tiantian;Qin Yikai;Lu Wen(Obstetrics and Gynecology Department of Hubei Aerospace Hospital,Zhongxiang,Hubei 432000,China)
出处
《四川医学》
CAS
2024年第3期286-291,共6页
Sichuan Medical Journal
