抑制素A和妊娠相关蛋白A在子痫前期中的研究

The study on the concentrations of serum PAPP-A and inhibin-A in pre-eclampsia patients

目的:探讨正常孕妇各孕周血清妊娠相关蛋白A(pregnancy-associated plasma protein-A,PAPP-A)和抑制素A(inhibin-A)的变化及其与子痫前期(pre-eclampsia)发病的关系。方法:采用时间分辩荧光免疫分析技术(DELFIA)检测孕20～41周妇女外周血PAPP-A浓度913例,其中正常孕妇880例,子痫前期孕妇33例;采用ELISA检测孕20～41周妇女外周血inhibin-A浓度724例,其中正常孕妇691例,子痫前期孕妇33例。统计分析子痫前期妇女及正常孕妇外周血清PAPP-A和inhibin-A的中位数差异。结果:正常孕妇血清PAPP-A和inhibin-A浓度值随孕周的增加而不断增高,至孕晚期达到最高水平;而子痫前期组PAPP-A和inhibin-A水平显著高于相应孕周正常孕妇组的中位数。结论:正常孕妇血清PAPP-A和inhibin-A浓度随妊娠进展而逐渐上升;子痫前期患者血清PAPP-A和inhibin-A浓度显著高于同孕周正常孕妇,但PAPP-A和inhibin-A两者间无相关性,PAPP-A和inhibin-A与子痫前期发病存在相关关系。

Objective： To evaluate the change of serum PAPP - A and inhibin - A with the progress of gestational weeks in healthy pregnant women, and the relationship between this change and the onset of preeclampsia. Methods： The concentration of PAPP - A in peripheric blood of 913 gravidas including 880 healthy and 33 preeclampsia pregnant women from 20 to 41 gestational weeks were examined by time - resolved fluoroimmuno assay （DELFIA） ; the concentration of inhibin - A in peripheric blood of 724 gravidas including 691 healthy and 33 preeclampsia pregnant women from 20 to 41 gestational weeks were examined by ELISA. The differences between the median of periphefic serum PAPP - A and the median of inhibin - A between healthy and preeclampsia gravidas were analyzed. Results： The concentrations of serum PAPP - A and inhibin - A in healthy pregnant women were raised with the progress of gestational weeks, and achieved peak in the late third trimester of pregnancy. However, the medians of PAPP - A and inhibin - A in the preeclampsia group obviously higher than that in the healthy group of corresponding gestational weeks. Conclusion： The concentrations of serum PAPP - A and inhibin - A increased gradually with the progress of pregnancy in healthy pregnant women; the concentrations of serum PAPP - A and inhibin - A in the preeclampsia gravidas were significantly higher than that in the healthy gravidas of corresponding gestational weeks, however, there was no correlation between the increase of PAPP- A and inhibin -A; the onset of preeclampsia is related to PAPP- A and inhibin- A.