唐氏筛查指标在子痫前期筛查中的应用及妊娠结局分析  

The Application of Down’s Syndrome Screening Indexes in the Screening of Preeclampsia and the Analysis of Pregnancy Outcomes

作　　者：赵咏梅[1] 张传英[1] 陈俭辉[1] 赵连芳 景亚玲 ZHAO Yong-mei;ZHANG Chuan-ying;CHEN Jian-hui;ZHAO Lian-fang;JING Ya-ling(Prenatal Diagnostic Laboratory,Suining Central Hospital,Suining 629000,China)

机构地区：[1]遂宁市中心医院产前诊断实验室

出　　处：《标记免疫分析与临床》2019年第12期2089-2092,2144,共5页Labeled Immunoassays and Clinical Medicine

基　　金：遂宁市级科技计划项目(编号:2013s18)

摘　　要：目的探讨唐氏筛查指标对子痫前期(PE)的预测价值及与妊娠结局的相关性。方法选取2017年1月至2018年9月在本院行规范产检并确诊PE的128例孕妇,根据严重程度分为轻度PE组77例与重度PE组51例,另随机抽取同期产检128例健康孕妇为对照组,所有孕妇在15~20^+6孕周行唐氏筛查,检测血清甲胎蛋白(AFP)、β-人绒毛膜促性腺素(β-hCG)、游离雌三醇(uE 3)水平,追踪孕妇妊娠结局并分析唐氏筛查指标与妊娠结局相关性,以血清AFP、β-hCG、uE 3水平绘制受试者工作特征曲线(ROC),评价唐氏筛查指标对PE的预测价值。结果三组血清AFP、β-hCG、uE 3水平比较差异有统计学意义(P<0.05),且轻度PE组、重度PE组血清AFP、uE 3显著低于对照组(P<0.05)、β-hCG显著高于对照组(P<0.05);轻度PE组、重度PE组血清AFP、uE 3比较差异无统计学意义(P>0.05),但轻度PE组β-hCG显著低于重度PE组(P<0.05);Spearman相关性分析结果显示,血清AFP与分娩孕周、新生儿出生体重、1min Apgar评分均呈正相关(P<0.05);β-hCG与1min Apgar评分呈负相关(P<0.05);uE 3与分娩孕周、新生儿出生体重均呈负相关(P<0.05);AFP、β-hCG、uE 3预测PE的ROC曲线下面积(AUC)分别为0.683、0.704、0.637,三者联合预测的AUC为0.787。结论唐氏筛查指标AFP、β-hCG、uE 3联合检测对PE有较好的预测价值,且与妊娠结局存在一定相关性。Objective To explore the predictive value of Down’s syndrome screening indexes on preeclampsia(PE)and its correlation with pregnancy outcomes.Methods A total of 128 pregnant women who underwent standardized production inspection and confirmed as PE in the hospital from January,2017 to September,2018 were selected and divided into the mild PE group(77 cases)and severe PE group(51 cases)according to the severity.Another 128 healthy pregnant women for production inspection during the same time period were randomly collected as the control group.All pregnant women were given Down’s syndrome screening at 15 to 20^+6 weeks of pregnancy,and the levels of serum alpha-fetoprotein(AFP),β-human chorionic gonadotropin(β-hCG)and uncojugated estriol(uE 3)were detected.The pregnancy outcomes of pregnant women were tracked and the correlation between Down’s syndrome screening indexes and pregnancy outcomes was analyzed.The receiver operating characteristic curve(ROC)was drawn using means of serum AFP,β-hCG and uE 3 levels in order to evaluate the predictive value of Down’s syndrome screening indexes on PE.Results There were significant differences in the levels of serum AFP,β-hCG and uE 3 among the three groups(P<0.05),and the levels of serum AFP and uE 3 in the mild PE group and severe PE group were significantly lower than those in the control group(P<0.05),while theβ-hCG was significantly higher than that in the control group(P<0.05).There were no significant differences in the levels of serum AFP and uE 3 between the mild PE group and severe PE group(P>0.05),butβ-hCG in the mild PE group was significantly lower than that in the severe PE group(P<0.05).Spearman correlation analysis showed that serum AFP was positively correlated with delivery gestational weeks,neonatal birth weight and 1min Apgar score(P<0.05).β-hCG was negatively correlated with 1min Apgar score(P<0.05).uE 3 was negatively correlated with delivery gestational weeks and neonatal birth weight(P<0.05).The values of area under the ROC curve(AUC)of

关 键 词：唐氏筛查 子痫前期 人绒毛膜促性腺素 游离雌三醇 甲胎蛋白 妊娠结局 

分 类 号：R71[医药卫生—妇产科学]