妊娠期HPV感染者血清PLGF、PAPP-A水平变化及其预测不良妊娠结局  

Changes of the serum placental growth factor(PLGF)and pregnancy associated plasma protein-A(PAPP-A)levels of pregnant women with human papillomavirus infection and the value analysis of the PLGF and PAPP-A levels for predicting the pregnancy outcomes

作　　者：谢峻 XIE Jun(Air General Hospital,Beijing,100012)

机构地区：[1]航空总医院,北京100012

出　　处：《中国计划生育学杂志》2025年第1期179-183,189,共6页Chinese Journal of Family Planning

摘　　要：目的:探讨妊娠期人乳头瘤病毒(HPV)感染孕妇血清胎盘生长因子(PLGF)、妊娠相关蛋白-A(PAPP-A)水平及其预测不良妊娠结局价值。方法:选取本院2021年1月-2023年1月收治的妊娠期HPV感染孕妇138例为感染组,同期产前检查无HPV感染孕妇138例为对照组。酶联免疫吸附实验法检测血清PLGF、PAPP-A水平,比较两组血清PLGF、PAPP-A水平及妊娠结局。根据妊娠结局将感染组分为妊娠良好组(n=107)和妊娠不良组(n=31)。应用多因素logistic回归分析妊娠期HPV感染者不良妊娠结局发生的影响因素;运用受试者工作特征(ROC)曲线分析妊娠期HPV感染者血清PLGF、PAPP-A水平预测不良妊娠价值。结果:感染组血清PLGF(52.16±7.91pg/ml)、PAPP-A(18.75±4.37ng/ml)水平均低于对照组(65.20±12.85ng/ml、29.25±6.79ng/ml),且感染组妊娠结局不良组HbAlc、FPG均低于妊娠结局良好组;感染组中妊娠不良者高危型HPV感染占比高于妊娠良好组,先兆流产发生率高于对照组,不良妊娠结局总发生率(22.5%)高于对照组(4.4%)(均P<0.05)。HPV感染高危型、血清PLGF降低、PAPP-A降低是影响妊娠期HPV感染者发生不良妊娠结局的影响因素(P<0.05)。妊娠期HPV感染者血清PLGF、PAPP-A联合预测不良妊娠结局最佳,其曲线下面积为0.907,敏感度74.2%、特异度91.6%。结论:妊娠期HPV感染者血清PLGF、PAPP-A水平降低,且均为不良妊娠结局影响因素,2项联合检测预测妊娠期HPV感染者不良妊娠结局有更高价值。Objective:To investigate the serum levels of placental growth factor(PLGF)and pregnancy associated plasma protein-A(PAPP-A)level of pregnant women with human papillomavirus(HPV)infection,and to study the value of the PLGF and PAPP-A levels for predicting the pregnancy outcomes of the women.Methods:From January 2021 to January 2023,138 pregnant women with HPV infection admitted to the hospital were included in study group,and 138 pregnant women without HPV infection who underwent prenatal examinations were included in control group.ELISA method was applied to detect the expression levels of the serum PLGF and PAPP-A of the women.The levels of the serum PLGF and PAPP-A,and the pregnancy outcomes of the women were compared between the two groups.According to the pregnancy outcomes,the women in the study group were divided into group A(107 women with the normal pregnancy outcomes)and group B(31 women with the adverse pregnancy outcomes).Multivariate logistic regression was applied to analyze the influencing factors of the adverse pregnancy outcomes of the women in the study group.Receiver operator characteristic(ROC)curve was applied to analyze the predictive value of the serum PLGF and PAPP-A levels of the women with HPV infection during pregnancy on their pregnancy outcomes.Results:The levels of PLGF(52.16±7.91 pg/ml)and PAPP-A(18.75±4.37 ng/ml)of the women in the study group were significantly lower than those(65.20±12.85 ng/ml and 29.25±6.79 ng/ml)of the women in the control group.The levels of PLGF and PAPP-A of the women in group B were significantly lower than those of the women in group A.The proportion of the high-risk HPV infection and the incidence of the threatened abortion of the women in group B were significantly higher than those of the women in group A.The total incidence of the adverse pregnancy outcomes(22.5%)of the women in group B was significantly higher than that(4.4%)of the women in group A(all P<0.05).The high-risk types of HPV infection,and the decreased serum PLGF and PAPP-A level of th

关 键 词：孕期 人乳头瘤病毒感染 胎盘生长因子 妊娠相关蛋白-A 不良妊娠结局 影响因素 预测 

分 类 号：R71[医药卫生—妇产科学]