PAPP-A、脐动脉S/D比值与子痫前期的相关性研究  

Expression of PAPP-A in maternal serum,umbilical cord serum and placental tissue and umbilical artery S/D in preeclampsia

作　　者：刘颖[1] 展新风[2] 甄军晖[3] 马道新[4] 罗霞[1] 

机构地区：[1]山东大学齐鲁医院妇产科,济南250012 [2]山东大学齐鲁医院超声科,济南250012 [3]山东大学齐鲁医院病理科,济南250012 [4]山东大学齐鲁医院血液科,济南250012

出　　处：《山东大学学报（医学版）》2013年第11期78-81,共4页Journal of Shandong University:Health Sciences

基　　金：山东省计生委资助项目(200715;200705)

摘　　要：目的研究子痫前期孕妇外周血、脐血和胎盘组织妊娠相关血浆蛋白A(PAPP-A)水平及脐动脉S/D,探讨PAPP-A、脐动脉S/D与子痫前期的关系。方法 52例子痫前期孕妇,按发病孕周不同分为早发型组(≤32周)30例和晚发型组(>32周)22例,相匹配孕周正常孕妇各14例为对照组1、2;彩超测胎儿脐动脉S/D;ELISA法和免疫组化法分别测血清及胎盘PAPP-A水平。结果①早发型组及晚发型组外周血PAPP-A均高于对照组1、2(P<0.05),且早发型组高于晚发型组(P<0.05);早发型组及晚发型组脐血PAPP-A均高于对照组2(P<0.05);②早发型组胎盘PAPP-A高于对照组2和晚发型组(P<0.05);③早发型组及晚发型组胎儿脐动脉S/D均高于对照组1、2(P<0.05),且早发型组高于晚发型组(P<0.05);④早发型组外周血PAPP-A水平与脐动脉S/D呈正相关(P<0.05)。结论早发型子痫前期孕妇外周血PAPP-A和脐动脉S/D均升高,提示PAPP-A与早发型子痫前期的胎盘功能紊乱及子痫前期预后有关。Objective To determine the maternal, umbilical cord serum alterations and placental pregnancy-associated plasma protein-A （PAPP-A） in preeclampsia （PE） and healthy pregnancies to assess if there is association between maternal and umbilical cord serum PAPP-A levels and umbilical artery systolic/diastolic （S/D） ratio in preeclampsia. Methods 52 pregnant women with PE were divided into early-onset group （n=30, onset time ≤ 32 gestational weeks） and late-onset group （n=22, onset time 〉 32 gestational weeks）. 28 healthy pregnant women were included as control 1 （n=14, gestational age ≤ 32 weeks） and control 2 （n=14, gestational age 〉 32 weeks）. Doppler velocimetry of umbilical artery systolic/diastolic （S/D） ratio was obtained in all fetuses. Enzyme-linked immunosorbent assay （ELISA） was used to detect the maternal and umbilical cord serum level of PAPP-A. Immunohistochemistry was used to detect placental PAPP-A expression. Results ① The maternal serum PAPP-A in early-onset and late-onset PE groups was significantly higher than that in control 1 and control 2 （P〈0.05）, and it was higher in the early-onset PE group than that in the late-onset PE group （P〈0.05）. The umbilical serum PAPP-A in early-onset and late-onset PE groups was significantly higher than that in control 2 （P〈0.05）. ② The placental PAPP-A in early-onset PE group was significantly higher than that in late-onset PE group and control 2 （P〉0.05）. ③ The umbilical artery S/D ratio in early-onset and late-onset PE groups was significantly higher than that in control 1 and control 2 （P〈0.05）, and it′s higher in early-onset PE group than that in late-onset group （P〈0.05）. ④ The maternal serum PAPP-A was positively correlated with umbilical artery S/D in early-onset PE group （P〈0.05）. Conclusion Maternal serum PAPP-A level and umbilical artery S/D ratio are elevated in early-onset PE pregnancies. There is a positive correlation between maternal PAPP-A and umbil

关 键 词：妊娠相关血浆蛋白A 早发型子痫前期 脐动脉S D 脐血 

分 类 号：R574[医药卫生—消化系统]