孕早期β-hCG、PAPP—A及胎儿颈项透明层厚度与早产的关系研究

The relationship study between 15-hCG and PAPP-A and nuchal translucency thickness levels in the frist-trimester and premature delivery

目的：探讨孕早期孕妇血清中β-hCG、妊娠相关血浆蛋白A（PAPP—A）水平及胎儿颈项透明层厚度（NT）与早产的关系。方法：前瞻性选取2015年2月至2016年2月在佛山市南海区妇幼保健院行产前检查并分娩的1822例孕妇，根据随访结果将其分为正常对照纽及早产组。孕11～13＋6周时采用时间分辨荧光免疫分析法检测孕妇血清中PAPP—A、B-hCG的水平，同时超声检查测量NT值，以中位数值倍数（MOM）表示，分析这三个指标与早产的相关性。结果：正常对照组β-hCG、PAPP—A和NT的MOM值平均值分别为1．02±0．78，1．04±0．72，0．97±0．59，早产组的β-hcG、PAPP-A和NT的MoM值平均值分别为1．42±0．82，0．82±0．70，1．38±0．78。两组比较，β-hCG、PAPP—A和NT值差异有统计学意义（P值〈0．05）。结论：孕早期B—hCG、PAPP—A和NT的检测可对早产进行评估，并对早产的诊断和预防提供早期的数据。

Objective： To study the relationship between the levels of serum β-hCG, pregnancy-associated plasma protein-A （PAPP-A） , nuchal translucency thickness in the frist-trimester and preterm delivery. Methods： A total of 1822 pregnant women who had antenatal care at Nanhai District maternal and child health hospital of Foshan City between February 2015 and February 2016 were selected prospectively. According to the outcome, they were defined as the control group and the preterm delivery group. PAPP-A, β-hCG level were measured by Time-resolved fluoroimmunoassay, and the nuchal translucency thickness （NT） value by ultrasound at 11-13＋6 gestational weeks. The concentrations and the NT values were expressed in multiple of median （MOM） The relevance between the three indicators and preterm delivery was analyzed. Results： The average of β-hCG MOM,PAPP-A MOM and NT MOM in the control group were 1.02＋0.78, 1.04＋0.72 and 0.97＋0.59 respectively, and in the preterm delivery group they were 1.42＋0.82, 0.82＋0.70, 1.38＋0.78. There were statistically significant difference in β-hCG, PAPP-A and NT levels （P〈0.05）. Conclusion： The determination of β-hCG, PAPP-A and NT in the frist-trimester could be used to assess preterm delivery and provide the basis for early prevention ofpreterm delivery.