妊娠相关血浆蛋白A在妊娠早期监测的应用价值  

The value of pregnancy-associated plasma protein A on monitoring early pregnancy.

作　　者：安娜[1] 方群[1] 陈建生[1] 陈筠虹[1] 

机构地区：[1]中山大学附属第一医院妇产科胎儿医学中心,510080

出　　处：《新医学》2004年第8期464-465,共2页Journal of New Medicine

摘　　要：目的 :探讨孕妇血清妊娠相关血浆蛋白A (pregnancy associatedplasmaproteinA ,PAPP A)在妊娠早期监测的应用价值。方法 :采用酶联免疫吸附试验测定 388名妊娠 6～ 14周孕妇血清PAPP A水平 ,并追踪妊娠结局。以其中 344名妊娠结局正常的孕妇的测定结果建立正常参考值。对 4 4例异常低值 [小于 0 5中位数倍数 (multiplesofthemedian ,MoM ) ]者进行分析。 结果 :正常妊娠 6～ 14周时 ,孕妇血清PAPP A水平随孕周增加而上升 ,妊娠 11周后迅速上升。 4 4例异常低值的孕妇中 ,39例(89% )随后出现妊娠异常 ,其中 2 8例随后出现流产征兆 ,6例胚胎死亡 ,先兆流产及流产的发生率为77% ;其余 10例中 ,2例宫内发育迟缓 ,1例α珠蛋白生成障碍性贫血 (海洋性贫血 )纯合子 ,2例结构畸形 ,5例为原因不明异常低值。结论 :孕妇血清PAPP A降低可作为早期妊娠的监测指标 ,预测尚未出现临床症状的流产 ;并可作为早期筛查胎儿发育异常及一些先天畸形的指标。Objective:To investigate the value of maternal serum pregnancy-associated plasma protein A(PAPP-A)on monitoring early pregnancy. Methods:By ELISA assay, serum PAPP-A was measured in 388 pregnant women during 6～14 gestational weeks. The reference range was established from 344 samples in which pregnant outcomes were normal. Forty-four women who had low PAPP-A value (<0.5 multiples of the median) were analyzed for their pregnancy results.Results:In normal pregnancy, maternal serum PAPP-A level increased during 6～14 gestational weeks and increased quickly after 11 gestational weeks.Of 44 cases with low le-vel PAPP-A, 39 showed that embryos or fetuses appeared abnormal, which accounted for 89%. Among those abnormal pregnancies, 28 appeared symptoms of threaten abortion and 6 had embryonic death. Total abortion rate was 77%. There were 2 fetuses with intrauterine growth retardation, 1 with α-thalassemia, another 2 with structural malformation, and 5 without any reasonable explanations. Conclusion: Low PAPP-A level can be used in monitoring early pregnancy, predicting abortion before clinical symptoms appear, as well as screening abnormal fetal development and some congenital malformations.

关 键 词：妊娠 血浆蛋白A 监测 应用价值 酶联免疫吸附试验 

分 类 号：R714.1[医药卫生—妇产科学]