早孕期(8~12周)血清D-二聚体、纤维蛋白原和妊娠相关蛋白A单独与联合预测稽留流产的效能

Efficiencies of serum D-dimer, fibrinogen, pregnancy-associated plasma protein-A alone and in combination to predict missed abortion in early pregnancy(8~12 weeks)

目的 探讨早孕期血清D-二聚体(DD)、纤维蛋白原(Fib)以及妊娠相关蛋白A联合预测稽留流产的效能。方法 选取170例四川省广安市人民医院妇产科早孕期(8~12周)产妇为研究对象,比较不同妊娠结局产妇早孕期(8~12周)DD、Fib和妊娠相关蛋白A水平,分各项指标对稽留流产预测效能。结果 初次孕检时,稽留流产组和先兆流产组血清DD显著高于正常妊娠组,Fib和妊娠相关蛋白A显著低于正常妊娠组(P <0.05),其中妊娠相关蛋白A在稽留流产组中水平显著低于先兆流产组(P <0.05);血清DD、Fib和妊娠相关蛋白A预测稽留流产曲线下面积分别为0.761、0.828和0.721,三者联合预测曲线下面积为0.923,敏感度和特异度达91.72%和81.53%。结论 血清DD、Fib和妊娠相关蛋白A对稽留流产预测效能良好,联合检测可提高稽留流产的早期诊断率。

Objective To investigate the efficiencies of serum D-dimer(D-D), fibrinogen(Fib), pregnancyassociated plasma protein-A(PAPP-A) alone and in combination to predict missed abortion in early pregnancy(8 ~ 12weeks). Methods A total of 170 puerperae were selected as the research objects to compare the levels of DD, Fib and pregnancy-related protein A during the first trimester(8 ~ 12 weeks) of puerperae with different pregnancy outcomes.Results During the first pregnancy examination, the serum DD in the missed abortion group and the threatened abortion group was significantly higher than that in the normal pregnancy group, and Fib and pregnancy-related protein A were significantly lower than those in the normal pregnancy group(P < 0.05), significantly lower than the threatened abortion group(P < 0.05). The areas under the curve of serum DD, Fib and pregnancy-related protein A for predicting missed abortion were 0.761, 0.828 and 0.721, respectively, and the combined prediction area of the three was 0.923, with sensitivity and specificity up to 91.72% and 81.53%. Conclusion Combination of serum D-D, Fib and PAPP-A can improve the predictive efficiency and early diagnosis rate of missed abortion.