PAPP-A、Netrin-1、PP13及雌三醇水平对胎儿生长受限的预测价值

Predictive values of levels of PAPP-A,Netrin-1,PP13 and estriol for fetal growth restriction

目的探讨血清妊娠相关蛋白-A(PAPP-A)、神经轴突导向因子-1(Netrin-1)、胎盘蛋白13(PP13)、雌三醇水平对胎儿生长受限的预测价值。方法将丽水市中心医院2015年3月至2016年12月收治的孕早期2 431例孕妇中胎儿生长受限的71例作为研究对象(观察组),此期间胎儿发育正常孕妇50例作为对照组。入院后空腹采集外周静脉血,分离血清,采用化学发光法测定雌三醇浓度,采用酶联免疫双抗体夹心法测定PAPP-A、Netrin-1、PP13浓度。结果观察组孕妇血清PAPP-A、Netrin-1、PP13、雌三醇阳性率高于对照组,差异均有统计学意义(χ2=23.742、18.643、26.179、25.530,Ps<0.05);观察组孕妇血清PAPP-A、Netrin-1、PP13、雌三醇水平低于对照组,差异均有统计学意义(χ2=14.122、38.476、17.322、14.747,Ps<0.05);血清PAPP-A、Netrin-1、PP13、雌三醇水平与胎儿生长受限呈负相关。结论血清PAPP-A、Netrin-1、PP13、雌三醇水平对胎儿生长受限均有一定的预测价值。

Objective To explore the predictive values of pregnancy associated plasma protein-A（PAPP-A）,axon guidance factor-1（Netrin-1）,placental protein 13（PP13）and estriol for fetal growth restriction.Methods 71 women in early pregnancy with fetal growth restriction were included in the observation group,with 50 cases of normal fetal development as the control group.The specimens of peripheral venous blood were collected.The level of estriol was determined by using chemiluminescence,and the levels of PAPP-A,Netrin-1 and PP13 were measured by using enzyme-linked immunosorbent assay.Results The positive rates of PAPP-A,Netrin-1,PP13 and estriol in the observation group were higher than those in control group,with statistically significant differences（χ^2=23.742,18.643,26.179,25.530;Ps〈0.05）.The changes of levels of PAPP-A,Netrin-1,PP13 and estriol in the observation group were lower than in control group,with statistically significant differences（χ^2=14.122,38.476,17.322,14.747;Ps〈0.05）.The levels of serum PAPP-A,Netrin-1,PP13 and estriol were negatively correlated with fetal growth retardation.Conclusion The levels of serum PAPP-A,Netrin-1,PP13 and estriol have certain predictive values for fetal growth restriction.