血清PAPP⁃A、MMP⁃9、妊娠晚期脐动脉S/D值预测FGR的临床价值  

The clinical value of serum PAPP⁃A,MMP⁃9 and umbilical artery S/D value in the third trimester of pregnancy in predicting FGR

作　　者：谢宁[1] 李红岩 李丽 XIE Ning;LI Hongyan;LI Li(Department of Obstetrics,The Affiliated Hospital of Jining Medical College,Jining,Shandong,China,272100;Department of Obstetrics,The People's Hospital of Zoucheng City,Zoucheng,Shandong,Chi-na,273500)

机构地区：[1]济宁医学院附属医院产科,山东济宁272100 [2]山东省邹城市人民医院产科,山东邹城273500

出　　处：《分子诊断与治疗杂志》2021年第8期1231-1234,1238,共5页Journal of Molecular Diagnostics and Therapy

基　　金：山东省医药卫生科技发展计划项目(2019WS0153)。

摘　　要：目的分析血清妊娠相关蛋白A(PAPP⁃A)、基质金属蛋白酶⁃9(MMP⁃9)、妊娠晚期脐动脉收缩期峰值流速/舒张末期流速(S/D)值预测胎儿宫内生长受限(FGR)的临床价值。方法选取2019年10月至2020年10月本院收治的132例妊娠晚期孕妇,根据检查情况,将37例检查出FGR的孕妇作为生长受限组,将95例正常孕妇作为对照组。比较两组血清PAPP⁃A、MMP⁃9、妊娠晚期脐动脉S/D值差异,采用Logistic回归分析影响FGR的相关因素,并予以ROC分析血清PAPP⁃A、MMP⁃9、妊娠晚期脐动脉S/D值对FGR的预测价值。结果生长受限组血清PAPP⁃A、MMP⁃9水平明显低于对照组,S/D值高于对照组,差异均有统计学意义(P<0.05)。Logistic分析结果显示,有低蛋白血症、存在羊水过少、存在胎盘异常、有孕期感染、血清PAPP⁃A、MMP⁃9、S/D值表达异常为影响FGR的独立危险因素(P<0.05)。ROC曲线结果显示,血清PAPP⁃A、MMP⁃9、妊娠晚期脐动脉S/D值的ROC曲线下面积分别为0.780、0.688、0.784,各指标联合的ROC曲线下面积为0.938,以联合检测的预测价值最佳(P<0.05)。结论血清PAPP⁃A、MMP⁃9、妊娠晚期脐动脉S/D值在FGR中呈异常表达状态,监测上述水平可提升对FGR的预测价值,以提高新生儿质量,降低死亡率。Objective To analyze the clinical value of serum pregnancy⁃associated plasma protein A(PAPP⁃A),matrix metalloproteinases⁃9(MMP⁃9),the peak systolic velocity/end diastolic velocity(S/D)value of the umbilical artery in the third trimester of pregnancy in predicting fetal growth restriction(FGR).Methods The 132 pregnant women in the third trimester of pregnancy admitted to this hospital from October 2019 to October 2020 were selected.According to the examination,37 pregnant women with FGR were select⁃ed as the growth restriction group,and 95 normal pregnant women were selected as the control group.The dif⁃ferences in serum PAPP⁃A,MMP⁃9,and S/D values of umbilical artery in the third trimester of pregnancy were compared between the two groups.Logistic regression was used to analyze the factors affecting FGR.The ROC was used to analyze the predictive value of serum PAPP⁃A,MMP⁃9,and S/D values of umbilical artery in the third trimester of pregnancy for FGR.Results The levels of serum PAPP⁃A and MMP⁃9 in the growth restriction group were significantly lower than those in the control group,and the S/D value was higher than that in the control group.The differences were statistically significant(P<0.05).The logistic analysis showed that hypoproteinemia,oligohydramnios,placental abnormalities,pregnancy infections,and abnormal expres⁃sion of serum PAPP⁃A,MMP⁃9,and S/D values were independent risk factors affecting FGR(P<0.05).The ROC curve results showed that the areas under the ROC curve of serum PAPP⁃A,MMP⁃9,and S/D of umbili⁃cal artery in the third trimester of pregnancy were 0.780,0.688,and 0.784,respectively.The area under the ROC curve of the combined indicators was 0.938,and the combined detection had the best predictive value(P<0.05).Conclusion Serum PAPP⁃A,MMP⁃9,and S/D of umbilical artery in the third trimester of preg⁃nancy are abnormally expressed in patients with FGR.Monitoring the levels of those indicators can improve the predictive value for FGR and the quality of ne

关 键 词：FGR PAPP⁃A MMP⁃9 妊娠晚期脐动脉S/D值 

分 类 号：R714.5[医药卫生—妇产科学]