血清抑制素A、激活素A联合子宫动脉血流阻力检测对子痫前期的预测价值  

Predictive Value of Serum Inhibin A,Activin A and Uterine Artery Blood Flow Resistance in Preeclampsia

作　　者：赵怿 曹冬如 刘亚杰 史峻梅 白月婷 ZHAO Yi;CAO Dong-ru;LIU Ya-jie(Obstetrics Ward 1,Haidian District Maternal and Child Health Hospital,BeiJing 100080,China)

机构地区：[1]北京市海淀区妇幼保健院产一区,北京100080

出　　处：《医学临床研究》2019年第12期2320-2322,共3页Journal of Clinical Research

摘　　要：【目的】探讨血清抑制素A(ACTA)、激活素A(INHA)联合子宫动脉血流阻力检测对子痫前期(PE)的预测价值。【方法】选取2016年10月至2018年3月在本院行唐氏筛查的10~13+6周孕妇192例,其中PE孕妇92例纳入观察组,正常妊娠孕妇100例为对照组,自建卡日抽取血样完成血清检测,全程追踪至分娩结束,采用酶联免疫吸附试验检测血清ACTA、INHA水平,采用彩色多普勒超声检测两组子宫动脉血流阻力参数[收缩期与舒张期流速比(S/D)、搏动指数(PI)、阻力指数(RI)]并比较,采用ROC曲线分析ACTA、INHA结合子宫动脉血流阻力检测对PE的预测价值。【结果】观察组血清ACTA、INHA、S/D、PI、RI水平高于对照组,且观察组中病情重度者显著高于病情轻度者(P<0.05);ROC曲线分析显示:ACTA、INHA联合子宫动脉血流阻力检测预测PE的灵敏度、特异度、准确度、曲线下面积(AUC)分别为0.85、0.81、0.80、0.804,显著高于各项指标单独预测。【结论】PE患者血清中ACTA、INHA显著增高,且子宫动脉血流阻力增大,同时联合检测ACTA、INHA及子宫动脉血流阻力对PE有较高预测价值。【Objective】To explore the predictive value of serum inhibin A(ACTA),activin A(INHA)combined with uterine artery blood flow resistance in preeclampsia(PE).【Methods】A total of 192 pregnant women with gestational weeks of 10 to 13+6 undergoing routine Down's screening in the hospital from October 2016 to March 2018 were selected as subjects(92 PE pregnant women were included in the study group,and 100 normal pregnant women were included in the control group).The blood samples were taken to complete the serum test on the day of applying for a card.The whole process was traced to the end of delivery.The levels of serum ACTA and INHA were measured by enzyme-linked immunosorbent assay.The parameters of uterine artery blood flow resistance[ratio of systolic to diastolic flow rates(S/D),pulsation index(PI),resistance index(RI)]were evaluated by color Doppler ultrasound.The differences of the above indicators of patients under different conditions in the study group were compared.The ROC curve was used to analyze the predictive value of ACTA and INHA combined with uterine artery blood flow resistance for PE.【Results】The levels of serum ACTA and INHA in the study group were higher than those in the control group.The levels of ACTA and INHA in patients with severe illness were higher than those with mild illness in the study group(P<0.05).The S/D,PI and RI in the study group were higher than those in the control group.The above three indexes in patients with severe illness were higher than those with mild illness in the study group(P<0.05).ROC curve analysis showed that the sensitivity,specificity,accuracy and the area under the curve(AUC)for predicting PE by ACTA and INHA combined with uterine artery blood flow resistance detection were 0.85,0.81,0.80,and 0.804,respectively,which were higher than those by either of them.【Conclusion】The serum of patients with PE is abnormal in ACTA and INHA.The resistance of uterine artery blood flow is increased.The combined detection of ACTA,INHA and uterine arterial blood

关 键 词：先兆子痫/诊断 抑制素类 激活素类 

分 类 号：R714.244[医药卫生—妇产科学]