妊娠早期孕妇血清解整合素-金属蛋白酶12水平变化与妊娠结局  

Correlation of a disintegrin and metalloprotease 12 level in maternal serum during the first trimester with pregnancy outcome

作　　者：戚红[1] 边旭明[1] 蒋宇林[1] 刘善英[1] 郭琦[1] 

机构地区：[1]中国医学科学院北京协和医院妇产科,100730

出　　处：《中华妇产科杂志》2009年第6期401-404,共4页Chinese Journal of Obstetrics and Gynecology

基　　金：国家科技部支撑计划（2006BA105A08）

摘　　要：目的探讨妊娠早期孕妇血清解整合素-金属蛋白酶12（ADAM12）-S水平变化与妊娠结局的关系。方法选择2007年7月至2008年1月就诊于北京协和医院的511例早孕期（6～13周）孕妇，应用时间分辨荧光免疫分析法检测其血清中ADAM12-S水平，并分析ADAM12-S水平变化与妊娠结局的关系。结果（1）511例孕6、7、8、9、10、11、12、13周孕妇血清中ADAM12-S水平的中位数分别为14．63、35．08、88．90、186．51、370．62、537．71、632．55及769．42μg／L。呈现出血清ADAM12．S水平随孕周增加而逐渐上升的趋势，且呈线性相关（r=0．992，P〈0．01）。（2）511例孕妇中正常单胎孕妇427例，各种不良妊娠结局84例。胚胎停止发育（胎停育）27例，发生率为5．3％（27／511），异位妊娠5例，胎停育及异位妊娠孕妇血清中ADAM12-S水平的中位数倍数（MOM）值明显低于正常单胎孕妇，差异有统计学意义（P〈0．05）。前置胎盘孕妇ADAM12-S水平的MOM值则高于正常单胎孕妇，差异有统计学意义（P〈0．05）。473例新生儿出生体重均与孕妇ADAM12-S水平无明显相关性（r=-0．15，P〈0．05）。（3）82例因高龄、中孕期血清学及超声筛查高危孕妇进行了羊水细胞、绒毛细胞或脐血细胞染色体核型分析，发现染色体异常者4例，其中21三体综合征2例，特纳综合征2例；因胎停育行绒毛细胞染色体分析15例，发现9例染色体异常（60％，其中1例为21三体综合征）。13例非整倍体染色体异常孕妇的ADAM12-S水平的MOM值为0．34，明显低于正常单胎孕妇的1．01，差异有统计学意义（P〈0．05）；10例常染色体异常孕妇的平均MOM值为0．29，明显低于正常单胎孕妇，差异有统计学意义（P〈0．05）。结论早孕期孕妇血清中ADAM12-S水平随孕周增加而上升，可用于非整倍体常染色体异常的筛查，同时还可预测胎停育、异位妊娠等早期妊Objective To explore the relationship between pregnant outcomes and the maternal serum level of a disintegrin and metalloprotease 12 （ADAM 12 ） in the first trimester. Methods From July 2007 to January 2008, the serum levels of ADAM 12 of 511 women in their first trimester（ 6 - 13 gestational weeks） , who attended the clinics at Peking Union Medical College Hospital, were tested by Time-Resolved Fluorescence Immunoassay （ TR-FIA）, and the results and pregnant outcomes were analyzed. Results （ 1 ） The median levels of ADAM 12 at 6,7,8,9,10,11,12, 13 weeks of gestation were 14. 63 μg/L, 35.08 μg/L, 88.90 μg/L, 186. 51 μg,/L, 370. 62 μg/L, 537. 71 μg/L, 632. 55 μg/L, and 769. 42 μg/L, respectively, showing a linear increase with the gestational age （r = 0. 992, P 〈 0. 01 ）. （2） Among the 511 pregnancies, 427 were normal singleton term pregnancies and 84 had adverse perinatal outcomes. Twenty-seven miscarriages （5.3 % , 27/511 ） and 5 ectopic pregnancies were reported and the Multiple of Medians （ MOM ） of them were 0. 24 and 0. 32, respectively, which was significantly lower than the normal singleton pregnancies（1. 01, P 〈0. 05）. However, the serum level of ADAM 12 in 5 women with placenta previa （ MOM = 1.45 ） was significantly higher than the normal ones （ P 〈 0. 05 ）. No significant correlation was found between the fetal birth weight and maternal serum level of ADAM 12 in the first trimester （r = -0. 15, P 〈 0.05 ）. （3） Thirteen cases with chromosomal abnormalities was identified out of 97 cases who received fetal karyotyping, including 3 Down＇s syndrome and 2 Turner syndrome, and the MOM of ADAM 12 in these 13 cases （0. 34） was significantly different from those normal singleton pregnancies （P 〈0. 05）. MoMs of ADAM 12 in 10 euchromosome aneupolyhaploids cases（0.29）were lower than the normal ones（ P 〈 0. 05 ）. Conclusion The maternal serum level of ADAM 12 in the first-trimester is a potential marker for aneupolyhaploid scr

关 键 词：妊娠初期 膜蛋白质类 ADAM蛋白质类 妊娠结局 

分 类 号：R686[医药卫生—骨科学]