血清PAPP-A、AFP及uE3联合检测预测子痫前期的临床价值

Serum PAPP-A,AFP and uE3 as biomarker for pre eclampsia diagnosis

目的:探讨血清妊娠相关血浆蛋白(PAPP-A)、甲胎蛋白(AFP)及游离雌三醇(uE3)联合检测预测子痫前期的临床价值。方法:选择子痫前期患者38例(轻度子痫前期21例,重度17例)同期正常妊娠者40例作为研究对象。采用ELISA方法检测两组人群血清PAPP-A、AFP及uE3浓度。比较两组人群中血清PAPP-A、AFP及uE3蛋白水平有无差别。根据贝叶斯定理,评价血清PAPP-A、AFP、uE3及三者联合作为参考指标预测子痫前期的临床价值。结果:对照组血清PAPP-A、AFP及uE3蛋白水平显著高于子痫前期组(P<0.05);且轻度子痫前期组显著高于重度子痫前期组(P<0.05);分别以血清PAPP-A、AFP、uE3及三者联合为参考指标预测子痫前期的敏感性分别为67.3%,62.7%,60.8%和73.6%,特异性分别为66.1%,63.2%,60.0%及70.6%。诊断的ROC曲线下面积分别为0.75,0.72,0.70及0.81。结论:子痫前期患者血清PAPP-A、AFP及uE3表达水平明显降低,可作为预测子痫前期的血清学标志物,且三项指标联合检测对子痫前期有较高的预测价值。

Objective:The aim of this study was to evaluate the clincial efficacy of serum PAPP-A,AFP and uE3 as biomarker for pre eclampsia diagnosis.Methods:Thirty-eight pre eclampsia patients(21 mild and 17 serever cases)and 40 normal pregnancy women were included in this study.Serum concentrations of PAPP-A,AFP and uE3 were detected by ELISA assay in two groups and compared between the two groups.According to Bias's theorem,we evaluated the clinical value of serum PAPP-A,AFP,uE3 and the combination of the three as a reference index to predict preeclampsia.Results:The serum levels of PAPP-A,AFP and uE3 in the control group were significantly higher than those in the pre eclampsia group(P<0.05),and those in the mild pre eclampsia group were significantly higher than those in the severe preeclampsia group(P<0.05).The sensitivity of predicting preeclampsia by serum PAPP-A,AFP,uE3 and three combinations were 67.3%,62.7%,60.8%and 73.6%,respectively,and the specificity was 66.1%,63.2%,60%and 70.6%respectively.The area under the diagnostic ROC curve was 0.75,0.72,0.70,and 0.81 for serum PAPP-A,AFP and uE3,respectively.Conclusion:The serum levels of PAPP-A,AFP and uE3 are significantly decreased in preeclampsia patients,which can be used as serological markers for predicting preeclampsia.