不同生化标志物检测用于预测子痫前期的临床价值

Clinical Value of Detection of Different Biochemical Markers in Predicting Preeclampsia

目的分析外周血中不同生化标志物胎盘蛋白-13(PP13)、胎盘生长因子(PLGF)检测用于预测子痫前期(PE)的临床价值。方法选取具有PE高危因素的孕妇120例,根据预后观察结果分为正常妊娠组(n=25)、轻度PE组(n=59)及重度PE组(n=36)。所有患者均于妊娠13、16、19周检测血清中PP13、PLGF水平,当妊娠13、16、19周血清PP13、PLGF水平均异常时判定为PP13阳性和PLGF阳性。用Med Calc软件行受试者工作曲线(ROC)分析PP13与PLGF预测PE发生的灵敏度、特异性。结果三组在妊娠13、16、19周时血清PP13、PLGF水平比较差异均有统计学意义,即PP13、PLGF水平依次明显降低(P<0.05);其中正常妊娠组在妊娠13、16、19周时血清PP13、PLGF水平逐渐上升,差异有统计学意义(P<0.05);轻度PE组在16周时血清PP13、PLGF水平显著升高,与13周时相比差异有统计学意义(P<0.05),但19周时无明显增高,与16周时相比无统计学意义(P>0.05);重度PE组在妊娠13、16、19周时血清PP13、PLGF水平则依次显著降低,差异有统计学意义(P<0.05)。PP13联合PLGF检测对于预测PE的灵敏度、特异度分别为92.63%、88.00%,明显高于PP13、PLGF单独检测的82.10%、72.00和78.95%、64.00%,且PP13联合PLGF检测曲线下面积(AUC)明显大于PP13、PLGF单独检测。结论孕早期血清PP13联合PLGF检测对临床预测PE的发生有重要价值。

Objective To analyze the clinical value of detection of different biochemical markers such as placental protein-13 （PP13） and placental growth factor （PLGF） in peripheral blood in predicting preeclampsia （PE）.Methods 120 cases of pregnant women with high risk factors of PE were selected and divided into the normal pregnancy group （n=25）, mild PE group （n=59） and severe PE group （n=36）.Levels of serum PP13 and PLGF of all patients were detected at the 13^th week, 16^th week and 19th week of pregnancy, and abnormal levels indicated positive PP13 and PLGF.MedCalc software was used for receiver operating characteristic （ROC） analysis to analyze the sensitivity and specificity of PP13 and PLGF in predicting the occurrence of PE.Results There were significant differences in serum PP13 and PLGF levels among the three groups at the 13th week, 16th week and 19th week of pregnancy, i.e., PP13 and PLGF levels significantly decreased in order （P〈0.05）, while the levels in the normal pregnancy group increased gradually at the 13th week, 16th week and 19th week of pregnancy （P〈0.05）.The levels in mild PE group significantly increased at the 16th week, compared with those at the 13th week （P〈0.05）, but there was no significant upregulation at the 19th week, and there was no significant difference, compared with those at the 16th week （P〉0.05）.The levels in severe PE group significantly decreased at the 13th week, 16th week and 19th week of pregnancy （P〈0.05）.The sensitivity and specificity of PP13 and PLGF in predicting PE （92.63%, 88.00%） were significantly higher than those of PP13 or PLGF alone （82.10% and 72.00%, 78.95% and 64.00%）, and the area under the curve （AUC） of PP13 combined with PLGF detection was significantly larger than that of PP13 or PLGF alone detection.Conclusion Early detection of serum PP13 combined with PLGF is of great value in predicting the occurrence of PE.