妊娠早期血清PlGF、PAPP-A、MAP预测子痫前期

Serum placental growth factor and pregnancy associated plasma protein A levels,and the mean arterial pressure value of pregnant women during the first trimester of pregnancy for predicting preeclampsia occurrence

目的:分析妊娠早期孕妇血清人胎盘生长因子(PlGF)、妊娠相关血浆蛋白-A(PAPP-A)、平均动脉压(MAP)对子痫前期(PE)预测价值。方法:选择2019年1月-2020年10月两个医院早孕建卡孕妇,酶联免疫吸附试验测定妊娠早期血清PlGF、PAPP-A及MAP,随访妊娠结局。根据妊娠结局分为PE组85例与非PE组170例,PE组分为重度PE(21例)与轻度PE组(64例)、早发型PE组(18例)与晚发型PE组(67例)。结果:PE组血清PlGF、PAPP-A水平低于非PE组,MAP高于非PE组(P<0.001);重度PE组、早发型PE组血清PlGF、PAPP-A水平低于轻度PE组、晚发型PE组(P<0.05),重度PE组与轻度PE组、早发型PE组与晚发型PE组MAP均无差异。PlGF、PAPP-A、MAP对PE具有预测效能,3项联合预测PE的效能、敏感度及特异性均高于单独指标(P<0.05);PlGF、PAPP-A对重度PE、晚发型PE均具有预测效能,两项联合预测重度PE及早发型PE的AUC、敏感度及特异性均高于单独指标(P<0.05);MAP对重度PE及早发型PE不具有预测价值(P>0.05)。结论:妊娠早期PlGF、PAPP-A及MAP联合对PE及其类型具有较好的预测效能。

Objective:To analyze the value of the levels of serum placental growth factor(PLGF)and pregnancy associated plasma protein A(PAPP-A),and the mean arterial pressure(MAP)of pregnant women during the first trimester of pregnancy for predicting preeclampsia(PE)occurrence.Methods:Pregnant women during the first trimester of pregnancy were selected as the research subjects from January 2019 to October 2020.The serum PLGF and PAPP-A of these women were detected by enzyme linked immunosorbent assay(ELISA),their MAP value was measured,and their pregnancy outcomes were followed up.According to PE occurrence,these women were divided into 85 cases with PE in group A and 170 cases without PE in group B.The women in group A were further divided into group A1(21 cases with severe PE)and group A2(64 cases with mild PE group),or group A3(18 cases with early onset PE)and group A4(67 cases with late onset PE).Results:The levels of serum PlGF and PAPP-A of the women in group A were significantly lower than those of the women in group B,and the MAP value of the women in group A was significantly higher(P<0.001).The levels of serum PlGF and PAPP-A of the women in group A1 were significantly lower than those of the women in group A2,and the levels of serum PlGF and PAPP-A of the women in group A3 were significantly lower than those of the women in group A4(P<0.05),and there was no significant difference in the MAP value of the women between group A1 and group A2,and between group A3 and group A4.The levels of serum PlGF and PAPP-A,and the MAP value had predictive efficacy for PE,and the efficacy,the sensitivity,and the specificity of the combined of the levels of serum PlGF and PAPP-A,and the MAP value for predicting PE were significantly higher than those of the serum PlGF level,the serum PAPP-A level,or the MAP value alone(P<0.05).The levels of serum PlGF and PAPP-A had predictive efficacy for severe PE or late onset PE,and AUC,the sensitivity,and the specificity of the combined of the levels of serum PlGF and PAPP-A for predicting severe PE or late onset PE were significantly higher than those of the serum PlGF level or the serum PAPP-A level alone(P<0.05).The MAP value of the women had no predictive efficacy for severe PE or late onset PE(P>0.05).Conclusion:The combined of the levels of serum PlGF and PAPP-A,and the MAP value of the pregnant women during the first trimester of pregnancy has better predictive efficiency for their preeclampsia occurrence and the preeclampsia type.