摘要
研究胎儿出生体重减少与孕14～18周后羊水中胰岛素样生长因子I(IGF-I)、IGFBP-I、瘦素及AFP水平的关系,评价这些生化指标的诊断价值。研究设计:纵向前瞻性研究。在孕14～18周后为孕妇行羊膜腔穿刺术。研究对象:对照组86例,体重低于P10的IUGR儿18例,体重低于P5的IUGR儿17例。结果:IUGR的严重程度与IGF-I、IGFBP-I及瘦素水平之间无相关性;AFP水平与IUGR严重程度呈负相关。体重低于P10的IUGR的结果是S:65.7%,SP:56.9%,PPV:38.3%,NPV:80.3%,整体诊断符合率是65.6%。体重低于P5的IUGR结果是S:76.4%,SP:54.8%,PPV:21.65%,NPV:93.4%,整体诊断符合率是70.6%。结论:羊水中AFP水平的升高有助于检测出可能发展为IUGR的高危人群。
Objective: To determine the relation between weight deficit at birth and IGF- I, IGFBP-I, Leptin, and AFP levels in amniotic fluid after 14-18 weeks; to ass ess the diagnostic usefulness of these biochemical markers. Study design: Longit udinal, prospective study. Amniocentesis was performed in pregnant women after 1 4-18 weeks of gestation. Study population: 86 controls, 18 IUGR < 10 percentile , and 17 IUGR < 5 percentile. Results: No significant correlation was found betw een severity of IUGR and IGF-I, IGFBP-I, or Leptin. AFP was inversely correlat ed with severity of IUGR; results for the IUGR < 10 percentile were: S: 65.7%, SP: 56.9%, PPV: 38.3%, NPV: 80.3%, and an overall diagnostic capacity of 65.6 %. Results for the IUGR < 5 percentile were: S: 76.4%, SP: 54.8%, PPV: 21.6% , NPV: 93.4%were obtained, and an overall capacity of 70.6%. Conclusions: Elev ated values of AFP in amniotic fluid may help early detection of populations at risk of developing IUGR.
