建立孕中期产前筛查孕妇血清ADAM12-S中位数倍数参考区间的初步研究  

Preliminary study of establishing the reference interval value of the median of ADAM 12-S in second trimester

作　　者：梁飞[1] 魏魏[1] 李晓泽[1] 魏岳峰[1] 胡志鹏[1] 

机构地区：[1]山西省长治市妇幼保健院医学遗传室,046011

出　　处：《中国妇幼保健》2014年第4期589-592,共4页Maternal and Child Health Care of China

基　　金：山西省卫生厅科研课题〔201202001〕

摘　　要：目的：建立孕中期唐氏筛查孕妇血清解整合素金属蛋白酶12分泌型（ADAM12～S）中位数倍数的参考区间。方法：随机选择自愿参加孕中期唐氏综合征（DS）产前筛查并经随访证实分娩健康儿的孕妇孕16—20周血清样本285份，用时间分辨荧光免疫分析法检测血清ADAM12-S浓度；用SPSS15．0软件构建ADAM12～S与孕周间的回归关系，计算得到AD-AM12-S中位数倍数（MoM）值。将ADAM12-S初始浓度与消除孕周及年龄影响后的最终MoM值进行曲线拟合，最终得出正常人群的MoM值参考范围。同时选择发生宫内呼吸窘迫、先兆子痫、早产的孕妇测定其孕中期ADAM12-S浓度并转化成MoM值，利用正常人群的ADAM12-SMoM值参考范围预测发生宫内呼吸窘迫、先兆子痫、早产的灵敏度和特异性。结果：ADAM12-S中位数与孕周呈正相关，ADAM12-SMoM值中位数与孕妇年龄中位数呈负相关，与体重中位数存在负相关，但在回归分析中所有模型的回归系数不具有统计学意义。根据最终MoM值求的正常人群的MoM值的参考值范围为（0．53，1．55），根据正常孕妇ADAM12-S参考范围预测宫内呼吸窘迫孕妇的灵敏度和特异性分别为84．3％和80．9％，预测先兆子痫和早产的特异性均为80．4％，但灵敏度低分别为13．1％和10．0％。结论：根据ADAM12-S初始浓度与最终MoM值关系方程的建立，初步探索正常人群ADAM12-SMoM值参考范围，对临床开展利用ADAM12-S筛查不良妊娠的研究有重要意义。Objective： To establish the reference interval value of the median （MoM） of a disintegrin and metalloprotease 12 se- creting type （ADAM12 -S） in second trimester serum screening for Downg syndrome. Methods： The parturients who were voluntary partici- pants of second trimester screening program for Downg syndrome and were confirmed to labor healthy newborn by low up visit were randomly enrolled in this study. Totally 285 serum samples of the trimester （ from 16 to 20 weeks） were collected and the concentration of ADAM12 - S was determined by time resolved fluoroimmunoassay （ TRFIA ） . The regression relationship between concentration of ADAM12 - S and gestational age was analyzed with SPSS 15.0 software and then the optimal modal was selected for the calculation the MoM value of ADAM12 -S. The relationship between the MoM value and the age as well as body weight of parturients were analyzed, finally the MoM val- ue was adjusted on the basis of the gestational age and age parturients. The curve fitting of ADAM12 - S concentration and the adjusted MoM value were conducted and the model was optimized for the equation by eliminating the influence of gestational age and age of parturients, the ADAM12- S＇referenee range of normal pregantwomen were gotten. The ADAM12 -S concentration of pregnant women of second trimester with preeelampsia, premature delivery and intrauterine respiratory distress were analyzed, which were converted into MoM value. Aecoding to ADAM12 -S＇reference range, the sensitivity and specificity of predicting adverse pregnancy referred to above were eaeulated. Results： A positive correlation between the MoM value of ADAM12 - S and gestational age was shown , while a negative correlation between MoM value of ADAM12 - S and the median of parturients＇age was found. A negative correlation between the MOM value of ADAM12 - S and body weight was found, but no statistical significance was shown in regressive analysis. The initial MoM value was converted into final MoM value accor

关 键 词：解整合素金属蛋白酶12分泌型 不良妊娠 唐氏综合征 

分 类 号：R714.5[医药卫生—妇产科学]