子宫动脉舒张早期切迹联合孕早期血脂、妊娠相关血浆蛋白A对子痫前期的预测价值  

Prognostic value of uterine artery diastolic notch combined with early pregnancy blood lipid and pregnancy-related plasma protein A in preeclampsia

作　　者：陈炆励 余海燕 CHEN Wen-li;YU Hai-yan(Department of Obstetrics and Gynecology,West China Second Hospital of Sichuan University,Ministry of Education,Chengdu 610041;Department of Obstetrics and Gynecology,Key Laboratory of Birth Defects and Related Maternal and Child Diseases,Ministry of Education,Chengdu 610041;Department of Obstetrics,Deyang People's Hospital,Deyang 618000,Sichuan,China)

机构地区：[1]四川大学华西第二医院妇产科,四川成都610041 [2]出生缺陷与相关妇儿疾病教育部重点实验室,四川成都610041 [3]德阳市人民医院产科,四川德阳618000

出　　处：《川北医学院学报》2023年第1期41-44,共4页Journal of North Sichuan Medical College

基　　金：四川省卫健委普及项目(19PJ043)。

摘　　要：目的:探讨子宫动脉舒张早期切迹联合孕早期血脂、妊娠相关血浆蛋白A(PAPP-A)对子痫前期(PE)的预测价值。方法:选取100例PE孕妇为PE组,同期113例健康孕妇为健康组。比较两组孕妇早期血清血脂[血清总胆固醇(TC)、高密度脂蛋白(HDL)、甘油三酯(TG)、低密度脂蛋白(LDL)]、PAPP-A水平及子宫动脉舒张早期切迹指数;回归分析影响PE的因素,并构建NMLE模型,受试者工作特征曲线(ROC)分析其对PE的预测价值。结果:两组PE组孕妇早期血清TC、HDL、TG、LDL及PAPP-A水平高于健康组(P<0.05);左、右子宫动脉舒张早期切迹指数小于健康组(P<0.05)。回归分析显示,血清PAPP-A、TC、HDL、TG、LDL水平及左右子宫动脉舒张早期切迹指数均为PE的独立危险因素(P<0.05);构建NMLE预测模型为Log=-567.23+1.961×TC+0.975×HDL+1.002×TG+0.864×LDL-1.051×左切迹指数-1.226×右切迹指数+0.904×PAPP-A;ROC分析显示,其预测PE的曲线下面积(AUC)为0.754,特异度、敏感度分别为91.00%、55.75%。结论:子宫动脉舒张早期切迹联合早期血脂、PAPP-A对PE具有一定的临床预测价值,可协助预估孕妇PE风险。Objective:To explore the predictive value of early diastolic notch of uterine artery combined with early pregnancy blood lipid and pregnancy-related plasma protein A(PAPP-A) in preeclampsia(PE).Methods:100 pregnant women with PE admitted to hospital were retrospectively selected as PE group.A total of 113 healthy pregnant women in the same period were selected as control group.The levels of serum lipids [total cholesterol(TC),high density lipoprotein(HDL),triglyceride(TG),low density lipoprotein(LDL)],PAPP-A and the notch index of uterine artery in the early diastole were compared between the two groups.NMLE model was constructed and its predictive value was tested by receiver operating characteristic curve(ROC).Results:The concentrations of serum TC,HDL,TG,LDL and PAPP-A in PE group were higher than those in control group(P<0.05),while the early diastolic index of left and right uterine artery was lower than that in control group(P<0.05).Multivariate analysis showed that serum TC,HDL,TG,LDL,APP-A and the early diastolic index of the left and right uterine arteries were independent risk factors for PE(P<0.05).The NMLE prediction model was Log=-567.23+1.961*TC+0.975*HDL+1.002*TG+0.864*LDL-1.051*(left notch index)-1.226*( right notch index) +0.904*(PAPP-A),and ROC analysis showed that the AUC of PE prediction was 0.754,specificity and sensitivity were 91.00% and 55.75%,respectively.Conclusion:Early diastolic notch of uterine artery combined with early blood lipid and PAPP-A has certain clinical value in predicting PE,and can assist in predicting the risk of PE in pregnant women.

关 键 词：子痫前期 子宫动脉舒张早期切迹 早期血脂 妊娠相关血浆蛋白A 

分 类 号：R714.2[医药卫生—妇产科学]