微粒子化学发光法检测血清妊娠相关蛋白A对孕早期唐氏筛查的意义

The significance of detecting serous pregnancy-associated plasma protein A in the early stage of pregnancy for Down's syndrome screening by microsome chemiluminescence method

目的探讨微粒子化学发光法(MCLIA)检测血清妊娠相关蛋白A对孕早期唐氏筛查的意义。方法于2014年8月-2016年7月采用MCLIA对1 000例孕妇血清中妊娠相关蛋白A进行检测,比较不同年龄及体质量指数孕妇的血清妊娠相关蛋白A水平,利用羊水细胞染色体核型进行确诊,评价血清妊娠相关蛋白A在孕早期唐氏综合征筛查中的临床价值。结果 47例孕早期妇女血清中妊娠相关蛋白A水平较低,其中26例(55.32%)产妇生育唐氏患儿;孕早期血清妊娠相关蛋白A水平随孕周增加而呈上升趋势,孕周为9周~13周的孕妇中位血清妊娠相关蛋白A水平分别为0.87μg/ml、1.81μg/ml、2.94μg/ml、5.13μg/ml、7.76μg/ml;相同孕周中,高体质量指数及高龄孕妇中血清妊娠相关蛋白A水平较低。结论血清妊娠相关蛋白A可作为孕早期唐氏筛查的标志物,对预判妊娠结局有一定指导作用。

Objective To explore the significance of detecting serum levels of pregnancy-associated plasma protein A in the early stage of pregnancy for Down＇s syndrome screening by microsome chemiluminescence method（MCLIA）.Methods From August 2014 to July 2016,1 000 pregnant women in our hospital were selected as study subjects.The levels of serous pregnancy-associated plasma protein A were detected by MCLIA,and were compared in pregnant women with different age and body mass index.The chromosome karyotype test in amniotic fluid samples was adopted to make definite diagnosis and to evaluate the clinical value of serous pregnancy-associated protein A in the screening Down＇s syndrome in early pregnancy.Results The serous pregnancy-associated plasma protein A levels were low in 47 cases of early pregnant women,and 26 of them（55.32%） delivered children with Down＇s symdrome.The level of serous pregnancy-associated plasma protein A showed an ascending tendency along with the increase of gestational weeks,and the median of serous pregnancy-associated plasma protein A at 9-13 gestational weeks were 0.87 μg/ml,1.81 μg/ml,2.94 μg/ml,5.13 μg/ml and 7.76 μg/ml,respectively.Within the same gestational weeks,the higher the body mass index and age were,the lower the serous pregnancy-associated plasma protein A was.Conclusion Serous pregnancy-associated plasma protein A can be used as a marker of Down＇ s syndrome screening in early pregnancy,and is helpful for estimating pregnancy outcome.