血清标志物联合检测对子痫前期的诊断价值  

Diagnostic value of combined detection of serum markers in preeclampsia

作　　者：孙秋瑾[1] 杨现春 陆逊 吴亚楠 王敬 SUN Qiujin;YANY Xianchun;LU Xun;WU Ya′nan;WANG Jing(Department of Clinical Laboratory,Beijing Chaoyang Maternal and Child Health Hospital,Beijing 100021,China)

机构地区：[1]北京市朝阳区妇幼保健院检验科,北京100021

出　　处：《检验医学与临床》2023年第14期2012-2016,共5页Laboratory Medicine and Clinic

基　　金：北京市朝阳区科技计划项目(CYSF2055)。

摘　　要：目的 探讨胎盘生长因子(PIGF)、可溶性fms样酪氨酸激酶-1(sFlt-1)、游离雌三醇(μE3)、甲胎蛋白(AFP)、β-人绒毛膜促性腺激素(β-HCG)、尿素氮(BUN)、肌酐(Cr)、尿酸(UA)、钙(Ca)、镁(Mg)、无机磷(P)联合检测对子痫前期(PE)的诊断价值。方法 选取2020年9月至2021年12月该院38例早、中、晚孕期血清标本齐全的PE患者作为PE组,40例健康妊娠者作为对照组。对获得的标本进行上述11项标志物检测,比较两组早、中、晚孕期各项指标水平的差异,采用受试者工作特征曲线(ROC曲线)分析寻找诊断效能高的标志物。结果 PE组和对照组早孕期Cr、UA水平比较,差异均有统计学意义(P<0.05),诊断PE的ROC曲线下面积(AUC)分别为0.786和0.720;PE组和对照组中孕期sFlt-1、Cr、UA水平比较,差异均有统计学意义(P<0.05),诊断PE的AUC分别为0.718、0.720和0.714;PE组和对照组晚孕期UA、sFlt-1、Cr、PIGF、Mg水平比较,差异均有统计学意义(P<0.05),诊断PE的AUC分别为0.867、0.810、0.794、0.722和0.712,5项指标联合检测诊断PE的AUC为0.917,灵敏度和特异度分别为83.33%和92.86%,阳性预测值和阴性预测值分别为88.24%和89.66%。结论 UA、sFlt-1、Cr、PIGF、Mg 5项指标联合检测对PE具有良好的诊断价值;UA、Cr具有很好的早期预测价值。Objective To investigate the diagnostic value of combined detection of placental growth factor(PIGF),soluble fms-like tyrosine kinase-1(sFlt-1),free estriol(μE3),alpha-fetoprotein(AFP),β-human chorionic gonadotropin(β-HCG),blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),calcium(Ca),magnesium(Mg)and inorganic phosphorus(P)in preeclampsia(PE).Methods A total of 38 PE patients with complete serum samples in the early,middle and late pregancy in the hospital from September 2020 to December 2021 were selected as PE group,and 40 cases of healthy pregnant women were selected as control group.The obtained specimens were tested for the above 11 markers,and the differences in the levels of various indicators during early,middle and late pregnancy between the two groups were compared.The marker with high diagnostic efficiency was found by receiver operating characteristic(ROC)curve analysis.Results There were significant differences in Cr and UA levels in early pregnancy between PE group and control group(P<0.05),and the area under ROC curve(AUC)for the diagnosis of PE were 0.786 and 0.720 respectively.There were significant differences in the levels of sFlt-1,Cr and UA between the PE group and the control group during middle pregnancy(P<0.05),and the AUC for the diagnosis of PE were 0.718,0.720 and 0.714 respectively.There were significant differences in UA,sFlt-1,Cr,PIGF and Mg levels between PE group and control group in late pregnancy(P<0.05).The AUC for the diagnosis of PE were 0.867,0.810,0.794,0.722 and 0.712 respectively.The AUC for the diagnosis of PE of combined detection of the 5 indicators was 0.917,the sensitivity and specificity were 83.33%and 92.86%respectively,the positive predictive value and negative predictive value were 88.24%and 89.66%respectively.Conclusion The combined detection of UA,sFlt-1,Cr,PIGF and Mg has a good diagnostic value for PE.UA and Cr have good early predictive value.

关 键 词：子痫前期 胎盘生长因子 可溶性fms样酪氨酸激酶-1 肌酐 尿酸 镁 

分 类 号：R446.6[医药卫生—诊断学] R714.25[医药卫生—临床医学]