妊娠早期血清妊娠相关血浆蛋白A联合子宫动脉舒张早期切迹在预测子痫前期中的价值

Values of serum pregnancy-associated plasma protein A in early pregnancy combined with early uterine artery diastolic notch in predicting preeclampsia

目的探讨妊娠相关血浆蛋白A联合子宫动脉舒张早期切迹在预测子痫前期中的价值。方法前瞻性对产检孕妇在妊娠11~13^(+6)周分别测定左右侧子宫动脉舒张早期切迹指数、测定血清妊娠相关血浆蛋白A(PAPP-A)浓度。最终纳入在医院分娩、资料齐全且符合纳入标准病例共计261例,根据分娩时是否患子痫前期分为病例组73例和对照组188例,比较两组间各指标差异,并计算单指标及联合指标检测在预测子痫前期中的价值。结果病例组孕妇血清PAPP-A水平以及子宫动脉舒张早期切迹指数均低于对照组(P<0.05);联合指标检测预测子痫前期发病敏感度或特异度优于单指标预测(P<0.05)。结论在妊娠11~13^(+6)周利用PAPP-A联合子宫动脉舒张早期切迹预测子痫前期具有应用价值。

Objective To investigate the values of pregnancy-associated protein A combined with early uterine artery diastolic notch in predicting preeclampsia.Methods The early diastolic index of left and right uterine arteries and the concentration of serum pregnancy-associated plasma protein A(PAPP-A)in pregnant women who underwent labor examination in Yinchuan Maternal and Child Health Hospital from May 2020 to December 2021 were prospectively measured at 11 to 13^(+6) weeks of gestation.The final subjects included in the study cohort were 261 cases with medical records and delivered in our hospital with complete data and conforming to inclusion criteria.They were divided into case group(n=73)and control group(n=188)according to whether they had preeclampsia at the time of delivery.The differences of various indicators between the two groups were compared,and the value of single indicator and combined indicator detection in predicting preeclampsia was calculated.Results The levels of serum PAPP-A and early diastolic index of uterine artery in preeclampsia group were significantly lower than those in normal group(P<0.05).The sensitivity or specificity of combined detection in diagnosis of preeclampsia were significantly better than that of single indicator(P<0.05).Conclusion Pregnancy-associated protein A combined with early uterine artery diastolic notch in the prediction of preeclampsia at 11 to 13^(+6) weeks of gestation has application value and can be promoted in clinical practice.