血浆游离胎儿DNA浓度联合血清妊娠相关血浆蛋白-A、β-人绒毛膜促性腺激素检测对孕妇不良妊娠结局的预测价值  

The predictive value of plasma cell-free fetal DNA concentration combined with serum pregnancy-associated plasma protein-A and β-human chorionic gonadotropin detection for adverse pregnancy outcomes of pregnant women

作　　者：劳力 梁娇 蒙浣婷 艾文 杨仪心 LAO Li;LIANG Jiao;MENG Huanting;AI Wen;YANG Yixin(Department of Obstetrics and Gynecology,Foshan Fosun Chancheng Hospital,Foshan 528031,Guangdong,China;Department of Laboratory,Foshan Fosun Chancheng Hospital,Foshan 528031,Guangdong,China)

机构地区：[1]佛山复星禅诚医院妇产科,广东佛山528031 [2]佛山复星禅诚医院检验科,广东佛山528031

出　　处：《中国性科学》2024年第3期91-95,共5页Chinese Journal of Human Sexuality

基　　金：2022年佛山市自筹经费类科技计划项目(2220001004394)。

摘　　要：目的探讨血浆游离胎儿DNA(cff-DNA)浓度联合血清妊娠相关血浆蛋白-A(PAPP-A)和β-人绒毛膜促性腺激素(β-hCG)检测对孕妇不良妊娠结局的预测价值。方法选取2022年8月至2023年2月佛山复星禅诚医院收治的进行产检、唐氏筛查和无创产前DNA检查(NIPT)的195例孕妇作为研究对象。将发生不良妊娠结局的孕妇设为研究组(n=36),无不良妊娠结局的孕妇设为对照组(n=159)。检测两组血浆cff-DNA浓度、血清PAPP-A和β-hCG水平;采用Spearman分析血浆cff-DNA浓度、血清PAPP-A和β-hCG水平与不良妊娠结局的相关性;采用受试者工作特征(ROC)曲线分析血浆cff-DNA浓度、血清PAPP-A和β-hCG水平对不良妊娠结局的预测价值。结果与对照组比较,研究组血浆cff-DNA浓度和血清PAPP-A水平显著更低,血清β-hCG水平显著更高,差异具有统计学意义(P<0.05);Spearman分析结果显示,血浆cff-DNA浓度、血清PAPP-A和β-hCG水平与妊娠期高血压、子痫前期、早产、死胎、新生儿窒息和胎儿生长受限不良妊娠结局具有显著相关性(P<0.05);ROC曲线结果显示,血浆cff-DNA浓度单独预测孕妇不良妊娠结局的曲线下面积为0.807,截断值为11.82%;血清PAPP-A单独预测孕妇不良妊娠结局的曲线下面积为0.804,截断值为0.41;血清β-hCG单独预测孕妇不良妊娠结局的曲线下面积为0.815,截断值为2.56;预测效能比较结果显示,血浆cff-DNA浓度、血清PAPP-A和β-hCG水平联合预测孕妇不良妊娠结局的特异度(97.48%)和准确度(96.41%)均显著高于三者单独预测(P<0.05),误诊率(2.52%)显著低于三者单独预测(P<0.05)。结论血浆cff-DNA浓度联合血清PAPP-A、β-hCG检测对孕妇不良妊娠结局具有较高的预测价值。Objective To explore the predictive value of plasma cell-free fetal DNA(cff-DNA)concentration combined with serum pregnancy-associated plasma protein-A(PAPP-A)andβ-human chorionic gonadotropin(β-hCG)detection for adverse pregnancy outcomes of pregnant women.Methods A total of 195 pregnant women who underwent prenatal examination,Down's screening and non-invasive prenatal DNA test(NIPT)in Foshan Fosun Chancheng Hospital from August 2022 to February 2023 were selected as the study subjects.The pregnant women with adverse pregnancy outcomes were set as the study group(n=36),and those without adverse pregnancy outcomes were set as the control group(n=159).The plasma cff-DNA concentration,serum PAPP-A and β-hCG levels of the two groups were detected.Spearman analysis was applied to analyze the correlation between plasma cff-DNA concentration,serum PAPP-A and β-hCG levels and adverse pregnancy outcomes.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of plasma cff-DNA concentration,serum PAPP-A andβ-hCG levels for adverse pregnancy outcomes.Results Compared with the control group,the plasma cff-DNA concentration and serum PAPP-A were significantly lower in the study group(P<0.05),and the serum β-hCG level was significantly higher(P<0.05).Spearman analysis showed that the plasma cff-DNA concentration,serum PAPP-A and β-hCG levels were significantly correlated with the adverse pregnancy outcomes of gestational hypertension,preeclampsia,premature delivery,stillbirth,neonatal asphyxia and fetal growth restriction(P<0.05).ROC curve results showed that the area under the curve of plasma cff-DNA concentration alone for diagnosing adverse pregnancy outcomes of pregnant women was 0.807,and the cut-off value was 11.82%.The area under the curve of serum PAPP-A for the diagnosis of adverse pregnancy outcome of pregnant women alone was 0.804,and the cut-off value was 0.41.the area under the curve of serum β-hCG alone in diagnosing adverse pregnancy outcome of pregnant women was 0.815,a

关 键 词：血浆游离胎儿DNA浓度 妊娠相关血浆蛋白-A Β-人绒毛膜促性腺激素 不良妊娠结局 预测价值 

分 类 号：R714[医药卫生—妇产科学]