外周血uE3与ApPrx2和SAP在胎儿神经管畸形早期筛查中的价值及意义  

Value and significance of uE3,ApPrx2,SAP in peripheral blood in the early screening of fetal neural tube defects

作　　者：李艳杰 王舒莹[2] 李晓明[2] LI Yanjie;WANG Shuying;LI Xiaoming(Maternal and Child Health Hospital of Chengde City,Chengde,Hebei 067000,China;Affiliated Hospital of Chengde Medical College of Hebei Province,Chengde,Hebei 067000,China)

机构地区：[1]河北省承德市妇幼保健医院,河北承德067000 [2]河北省承德医学院附属医院,河北承德067000

出　　处：《中国优生与遗传杂志》2021年第2期221-225,共5页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨外周血游离雌三醇(uE3)、过氧化物氧化还原酶2(Ap Prx2)、淀粉样P物质(SAP)在胎儿神经管畸形(NTD)早期筛查中的价值及意义。方法选取2016年9月-2019年10月3988例于河北省承德市妇幼保健医院接受规律产检的孕妇作为研究对象进行前瞻性研究,根据是否发生NTD分为NTD组(n=31)、无NTD组(n=3957)。统计NTD分布情况,比较两组一般资料、外周血uE3、Ap Prx2、SAP水平,分析NTD的相关影响因素及外周血uE3、Ap Prx2、SAP筛查NTD的效能,并比较各指标高低危患者NTD发生率。结果3988例规律产检的孕妇中NTD检出率为0.78%。NTD组孕期发热、孕期服药情况与无NTD组比较,差异有统计学意义(P<0.05)。NTD组孕11~14周、15~17周、18~20周外周血uE3、SAP低于无NTD组,Ap Prx2高于无NTD组(P<0.05)。孕期发热、孕期服药、孕11~14周、15~17周、18~20周uE3、SAP降低,Ap Prx2是NTD发生的独立危险因素(P<0.001)。18~20周时,uE3筛查NTD的AUC最大,为0.855,敏感度、特异度分别为80.65%、81.44%。18~20周外周血uE3、Ap Prx2、SAP高危患者NTD发生率均高于低危患者(P<0.05)。结论外周血uE3、Ap Prx2、SAP在胎儿NTD早期筛查中具有一定价值,能辅助临床评估胎儿NTD发生风险。Objective To investigate the value and significance of unconjugated estriol(uE3),peroxiredoxin 2(ApPrx2)and serum amyloid P component(SAP)in peripheral blood in the early screening of fetal neural tube defects(NTD).Methods 3988 pregnant women who received regular check-ups in our hospital from September 2016 to October 2019 were selected as the research subjects for prospective research.According to whether NTD occurred,they were divided into NTD group(n=31)and non-NTD group(n=3957).The distribution of NTD was counted,and the general data,the levels of uE3,ApPrx2,and SAP in peripheral blood of the two groups were compared.The related influencing factors of NTD and the effectiveness of peripheral blood uE3,ApPrx2,SAP in screening NTD were analyzed,and the incidence of NTD in high-risk and low-risk patients with various indicators was compared.Results The detection rate of NTD among 3988 pregnant women undergoing regular delivery was 0.78%.There were statistically significant differences between the NTD group and the non-NTD group in terms of fever and medication during pregnancy(P<0.05).The peripheral blood uE3 and SAP in the NTD group were lower than those in the non-NTD group at 11–14 weeks,15–17 weeks,and 18–20 weeks gestation,and ApPrx2 was higher than that in the non-NTD group(P<0.05).Fever during pregnancy,medication during pregnancy,reduction of uE3,SAP and ApPrx2 at 11–14 weeks,15–17 weeks,and 18–20 weeks of pregnancy were independent risk factors for NTD(P<0.001).At 18–20 weeks,the AUC of uE3 for NTD screening was the largest,0.855,and the sensitivity and specificity were 80.65%and 81.44%,respectively.The incidence of NTD in high-risk patients with peripheral blood u E3,Ap Prx2,and SAP was higher than that in low-risk patients at 18-20 weeks(P<0.05).Conclusion uE3,ApPrx2,and SAP in peripheral blood have certain value in the early screening of fetal NTD,and can assist clinical assessment of the risk of fetal NTD.

关 键 词：游离雌三醇 过氧化物氧化还原酶2 血清淀粉样P物质 神经管畸形 早期筛查 

分 类 号：R714.5[医药卫生—妇产科学]