孕妇血浆中胎儿DNA含量与早产关系的研究  

The Relationship Between Fetal DNA in Maternal Plasma and Preterm Labour

作　　者：蒋荔[1] 金敏菲[1] 叶伟萍[1] 杨祖菁[1] 

机构地区：[1]上海交通大学医学院附属新华医院,上海200092

出　　处：《实用妇产科杂志》2009年第6期346-349,共4页Journal of Practical Obstetrics and Gynecology

基　　金：上海市教委上海高校选拔培养优秀青年教师科研专项基金(编号:06Y08)

摘　　要：目的:研究早产和先兆早产孕妇血浆胎儿DNA的含量以及临床意义。方法:选择孕满28周至不足37周出现自发性规律宫缩的孕妇(单男胎)51例,其中23例孕周<37周分娩为早产组;28例出现有威胁的早产宫缩但经抑制宫缩治疗后足月产为先兆早产组,另选择正常妊娠的孕妇25例为正常对照组。采用实时荧光定量PCR方法测定孕妇血浆中总DNA和胎儿DNA的量,非参数统计方法进行数据分析。结果:①早产组孕妇血浆总DNA量中位数7639.0拷贝/ml高于正常对照组6931.8拷贝/ml,差异有统计学意义(P<0.05);②早产组孕妇血浆胎儿DNA中位数为386.6拷贝/ml,先兆早产组为312.9拷贝/ml,均高于正常对照组230.5拷贝/ml,差异均有统计学意义(P<0.05);③以正常对照组孕妇血浆胎儿DNA量的第90百分位作为阳性预测值,早产组的阳性预测率为82.6%,先兆早产组为46.4%,差异有统计学意义(P<0.05)。结论:早产孕妇血浆中胎儿DNA水平升高,观察孕妇血浆中胎儿DNA变化可有助于发现存在早产的可能,便于及时干预和处理。Objective. To quantify the fetal DNA in preterm labor and threatened preterm labor maternal plasma and elucidate the clinical significance. Methods-Whole blood was drawn from 51 pregnant women （28 - 37 weeks gestation, singleton pregnancy, male fetus） with spontaneous regular uterine contraction, then divided into 3 groups： 23 case with 〈 37 gestational weeks as preterm labor group, 28 cases （with threatened uterine contraction but inhibited by tocolysis to term pregnancy） as threatened preterm labor group, 25 cases with normal pregnancy as control group. The fetal DNA and total DNA in matemal plasma were determined by real time fluorescent quantitation PCR. Nonparametric test was used for the statistic analysis. Results：①The total DNA level in preterm labor group （the median value was 7639.0 copies/ml） was significantly! higher than that in control group （the median value was 6931.8 copies/ml）. There was obvious statistic significance （ P〈 0.05）;②The median value of fetal DNA in maternal plasma was 386.6 c0pies/ml in preterm labor group, 312.9 copies/ml in threatened preterm labor group and 230.5 copies/ml in control group. The quantification of fetal DNA in study groups was significantly higher than that in control group. There was obvious statistic significance （ P 〈 0.05 ）. Compared with the quantification of fetal DNA in preterm delivery group and threatened preterm labour group, the former was also higher （ P 〈 0.05） ;③The 90 percentile rank of fetal DNA in normal maternal plasma was the predictive value. The positive predictive value was 82.6% in preterm labor group,46.4% in threatened preterm labor group. There was obvious statistic significance（ P 〈 0.05）. Conclusions：The fetal DNA level in plasma of preterm labor pregnant women is elevated. Observing the changes of fetal DNA in matemal plasma might conduce to discover preterm labor and favor for intervention in time and treatment.

关 键 词：早产 胎儿DNA 实时荧光定量PCR 

分 类 号：R714.21[医药卫生—妇产科学]