妊娠相关蛋白A初始中位数建立及早期筛查价值探讨

Study on the Establishment of the Initial Median of Pregnancy Associated Plasma Protein A and Its Value in the Early Screening

【目的】建立岳阳地区早孕期孕妇的血清妊娠相关蛋白A（PAPP—A）初始中位数，并探讨其在早孕期的产前筛查价值。【方法】采用时间分辨免疫荧光分析技术，对本院孕9～136周的2786例本地孕妇进行母血清产前筛查标志物PAPP—A检测，并利用非线性加权回归拟合方程计算早孕期初始中位数，同时随访其妊娠结局。【结果】建立了岳阳地区早孕期PAPP—A的初始中位数，其孕周变化趋势与软件内嵌参数一致，平均高约24％；初始中位数与软件内嵌参数相比，检测了更多的出生缺陷，并检测了所有染色体病患儿。【结论】种族、实验室系统误差对孕妇筛查标志物PAPPA的预期中位数浓度有影响，各筛查实验室应建立自己的初始中位数，以保证结果的可靠性。

[Objective] To establish the initial median of pregnancy associated plasma protein A（PAPP-A） in pregnant women during the first trimester gestation in Yueyang area, and to explore its value in the prenatal screening during early pregnancy. [Methods]The dissociation enhanced lanthanide fluoroimmunoassay was used to detect the maternal serum marker PAPP-A for prenatal screening in 2786 pregnant women at 9- 136 weeks. The initial median of PAPP-A during early pregnancy was calculated by using nonlinear weight regression fitting equation. Meanwhile the pregnant outcome was followed up. [Results]The initial median of PAPPA during early pregnancy in Yueyang area was established, and its change tendency with gestational age was in accordance with the original parameter inserted in software with above 24% at average. Compared with the o- riginal parameter inserted in software, the initial median could detect more birth defects and all chromosome disease children. [Conclusion]The differences among races and laboratory systems can influence the expected median concentration of the prenatal screening marker in maternal serum. Therefore, each laboratory should establish its own initial median in order to ensure the reliability of the results.