PAPP-A与子宫动脉多普勒在早发型子痫前期和胎儿生长受限预测中的价值  

Prediction values of pregnancy-associated plasma protein A and uterine artery doppler on early onset pre-eclampsia and fetal growth restriction

作　　者：王艳丽[1] 杨亚培[1] 宋欢欢[1] WANG Yan-li;YANG Ya-pei;SONG Huan-huan(Department of Obstetrics and Gynecology,the First People's Hospital of Zhengzhou,Zhengzhou 450004,Henan,China)

机构地区：[1]郑州市第一人民医院妇产科,河南郑州450004

出　　处：《广东医学》2021年第5期582-585,共4页Guangdong Medical Journal

摘　　要：目的分析早孕期母体外周血中妊娠相关血浆蛋白A(PAPP-A)、β-人绒毛膜促性腺激素(β-hCG)、中孕期子宫动脉搏动指数(PI)水平,探讨其对早发型子痫前期(EOPE)和胎儿生长受限(FGR)的预测价值。方法回顾性分析产科门诊正规产检的76例早发型子病前期(EOPE组)、48例胎儿生长受限(FGR组)和419例正常妊娠(NP组)的临床资料,比较各组早孕期外周血中PAPP-A、β-hCG水平和中孕期子宫动脉PI的差异,采用受试者工作特征(ROC)曲线评判各指标对EOPE和FGR的预测价值。结果与NP组相比,EOPE组和FGR组的PAPP-A MoM值降低(P<0.001);PI MoM值明显升高(P<0.001);而β-hCG MoM值与NP组相比差异无统计学意义(P>0.05)。ROC曲线分析结果显示,PAPP-A联合PI预测EOPE的ROC曲线下面积(AUC)和敏感度分别为0.89和75%,预测FGR的AUC和敏感度分别为0.80和67%,均高于单项指标检测。结论早孕期母体外周血中PAPP-A水平联合中孕期子宫动脉PI对EOPE和FGR有一定的预测价值,且方法简单、方便、易行。Objective To assess the maternal level of serum pregnancy-associated plasma protein A(PAPP-A)and β-human chorionic gonadotropin(β-hCG)in first trimester,and uterine artery pulsatility index(PI)in the second trimester;thus to assess the roles of these indexes in the prediction of early onset pre-eclampsia(EOPE)and fetal growth restriction(FGR).Methods Based on pregnancy outcomes,the patients who came to hospital for regular antenatal examination were retrospectively selected and categorized into normal pregnancy group(NP group),EOPE group and FGR group.The PAPP-A,β-hCG and uterine artery PI were compared.The efficacies of PAPP-A and uterine artery PI on the prediction of EOPE and FGR were investigated with receiver operating characteristic(ROC)curve.Results Compared with NP group,the PAPP-As were significantly lower in pregnancies complicated by EOPE and FGR(P<0.001).The median uterine artery PI were significantly higher in EOPE and FGR groups(P<0.001).However,the freeβ-hCG was not significantly different among the 3 groups NP(P>0.05).The combined detection of PAPP-A and uterine artery PI in prediction of EOPE and FGR were significantly higher than single detection alone,with area under the curve(AUC)of 0.87 and 0.81,respectively,and sensitivities of 74% and 67%,respectively.Conclusion The combination detection of first trimester PAPP-A and second trimester uterine artery PI improves the screening efficiency for the prediction of EOPE and FGR.

关 键 词：妊娠相关血浆蛋白A β-人绒毛膜促性腺激素、子宫动脉搏动指数 早发型子痫前期 胎儿生长受限 

分 类 号：R714.252[医药卫生—妇产科学] R446.62[医药卫生—临床医学]