孕妇血清妊娠相关蛋白A检测及妊娠结局分析

Determination of serum pregnancy associated plasma protein A(PAPP-A) in pregnancy women and analysis outcome of the pregnancy

目的探讨妊娠相关蛋白A(PAPP-A)作为血清标记物在孕早期产前筛查中应用的价值。方法用酶联免疫吸附法(ELISA)测定孕9～14周孕妇血清中PAPP-A浓度,检测结果低于正常下限值的孕妇视为胎儿染色体异常的高危人群,并对其进一步行羊水染色体检查及B超检查,每例受检的孕妇随访追踪到胎儿出生。结果共检测1380例9～14周单胎妊娠孕妇,筛查出PAPP-A低值的高危孕妇107例,确诊染色体异常3例(2例21-三体,1例47,XXY),高危组不良妊娠结局9例,筛查高危组与筛查低风险组不良妊娠结局比较有显著差异(χ2=39.36,P<0.01)。结论PAPP-A可作为孕早期染色体三体异常筛查的一个指标,对于PAPP-A低值的孕妇提示有不良妊娠结局的可能。

Objective:To investigate the value of determination of the serum marker PAPP-A for screening testing early pregnancy. Methods:Serum PAPP-A concentration were determined with ELISA in early (9～14 weeks) gestation, Pregnant women were assumed in high risk group of fetal chromosome abnormal if their PAPP-A concentration were below lower limit. Chromosome examination of amniotic fluid and B-ultrasonography were further performed, follow-up study was continued until fetalbirth. Results:Altogether 1380 pregnancy women were tested,107 of which were regarded as of high risk group.Among high risk once, 3 cases with fetal chromosome abnormality (two cases trisomy 21 and one case 47,XXY)were identified,outcome of the Pregnancy was terminated unfavorably in 6 womenof them, the unfavorable rate was significantly higher than that in the non-high risk group(χ2=39.36,P<0.01).Conclusion: PAPP-Aisa very usefulmarker for serum screening of chromosome trisomy abnormality in early pregnancy,and depressed levels also suggest a possible unfavorable outcome of the Pregnancy.