孕早期母血清PAPP-A对妊娠期高血压疾病的预测  

Prediction of hypertensivedisorders in pregnancy by first trimester maternal serum pregnancy associated plasma protein A (PAPP-A)

作　　者：皇甫英[1] 杨伟彬[1] 郑玮琳[1] 张伟[2] 李维[2] 曾丽珍[2] 李文雅[2] 张静[2] 

机构地区：[1]深圳市南山区妇幼保健院产科,深圳518052 [2]深圳市南山区妇幼保健院检验科,深圳518052

出　　处：《中国优生与遗传杂志》2014年第4期68-70,共3页Chinese Journal of Birth Health & Heredity

基　　金：深圳市科技局基金;编号:201202175

摘　　要：目的回顾性分析孕早期母血清PAPP—A与妊娠期高血压疾病的相关性及预测价值。方法收集深圳南山区妇幼保健院早孕期唐氏综合征筛查病例10056例，10-13＋6周采血后通过电话和妇幼信．g-系统随访到胎儿出生后3个月。将孕期胎儿结构正常、未发生妊娠并发症和出生后新生儿正常孕妇6915例作为正常对照组，分析对照组母血清PAPP—A水平与轻度子痫前期（MPE），重度子痫前期（SPE）和妊娠期高血压（PIH）的差异，探讨PAPP—A对上述疾病的预测价值；同时分析PAPP—A与病例组孕期血压，新生儿出生体重的关系。结果1．MPE、SPE和PIH组PAPP—AMOM中位数明显均低于对照组（P〈0．001）；病例组孕妇PAPP—A水平与孕期最高收缩压（r=-0．303，P〈0．01），孕中期收缩压（r=-0．251，P〈0．05）呈负相关，与新生儿出生体重呈正相关（r=0．267，P〈0．05）。2．用ROC曲线分析低PAPP—A水平对SPE，MPE，PIH的预测价值，曲线下面积（AUCROC）分别为0．694（P〈0．0001），0．658（P〈0．001）和0．616（P〈0．001）。结论孕早期母血清低PAPP—A水平与随后发展为妊娠期高血压疾病相关，对重症子痫前期有较好的预测价值。Objective： To investigated the value of first trimester maternal serum pregnancy associated plasma protein A （ PAPP - A） as predictor of Hypertensivedisorders in Pregnancy. Methods： There were 10056 pregnancies who received Down syndrome screen- ing at first trimester in clinic in NanShan Maternity and Children Hospital. In the 6915 pregnancies with follow up PAPP - A and free 13 - hCG were compared between those with normal outcome and those resulting in pregnancy induced hypertension and Pre - eclampsi- a. Results 1. The multiple of median （MOM） maternal serum PAPP - A was significantly lower in those pregnancies resulting in preg- nancy induced hypertension （PIH） , mild Pre- eclampsia （MPE）, and severe Pre -eclampsia （SPE）. It was negative correlation between PAPP - A MOM and peak systolic pressure during pregnancy （ r = - 0. 303, P 〈 0. 01 ） , systolic pressure at second trimester （r = - 0. 251, P 〈 0. 05 ）, but positive correlation between PAPP - A MOM and low birthweight （ r = 0. 267, P 〈 0. 05 ）. 2. Receiver operator characteristic curve （ROC） analysis showed Area under ROC Curve （AUCROC） for SPE, MPE and PIH was 0. 694 （ P 〈 0. 0001 ）, 0. 658 （ P 〈 0. 001 ） and 0. 616 （ P 〈 0. 001 ）, respectively. Conclusion： Low maternal serum PAPP - A at I0 - 13 ＋6 weeks of gestation are associated with subsequent development of p Pill , PE. This marker could be used as a predictor of Severe Pre - eclampsia.

关 键 词：孕早期 血清学筛查 PAPP—A 子痫前期 妊娠期高血压 

分 类 号：R714.25[医药卫生—妇产科学]