血清糖类抗原125及基质金属蛋白酶-9检测在胎盘早剥预测中的价值分析

Value of serum carbohydrate antigen 125 and matrix metalloproteinase-9 in predicting placental abruption

目的:探讨血清糖类抗原125(CA125)、基质金属蛋白酶-9(MMP-9)及二者联合检测在胎盘早剥中的预测价值。方法:选取经阴道分娩或剖宫产后胎盘早剥孕妇91例为胎盘早剥组,选取同期经阴道分娩或剖宫术正常胎盘者85例为对照组。采用酶联免疫法(ELISA)检测研究对象CA125、MMP-9水平,应用Logistic回归分析诊断胎盘早剥的相关指标,建立Logistic回归方程,并通过受试者工作特征曲线(ROC)进行分析。结果:与对照组相比,胎盘早剥组CA125显著升高(P<0.05)、MMP-9显著降低(P<0.05);孕妇血清CA125在胎盘早剥预测中曲线下面积为0.875,敏感度为87.9%,特异性为87.1%,血清浓度>95.17 U/ml时有胎盘早剥风险;孕妇血清MMP-9在胎盘早剥诊断中曲线下面积为0.882,敏感度为89.0%,特异性为90.6%,血清浓度<121.21 ng/ml时有胎盘早剥风险,二者联合在胎盘早剥诊断中曲线下面积为0.965,敏感度93.4%,特异性为90.5%,Pre-1>0.534时有胎盘早剥风险。结论:联合血清CA125与MMP-9检测对预测胎盘早剥具有一定临床价值,有助于提高诊断的准确性与科学性。

Objective:To investigate the predictive value of serum carbohydrate antigen 125(CA125),matrix metalloproteinase-9(MMP-9) and their combination in placental abruption.Methods:A total of 91 pregnant women with placental abruption after vaginal delivery or cesarean section were selected as placental abruption group,and 85 normal placentae after vaginal delivery or cesarean section were selected as control group.The levels of CA125 and MMP-9 were detected by enzyme-linked immunosorbent assay(ELISA).Logistic regression was used to analyze the relevant indexes for diagnosing placental abruption.Logistic regression equation was established and analyzed by receiver operating characteristic(ROC) curve.Results:Compared with the control group,the CA125 was significantly increased and the MMP-9 was significantly decreased(all P<0.05) in the placental abruption group.The area under the curve of serum CA125 in the prediction of placental abruption was 0.875,the sensitivity was 87.9%,the specificity was 87.1%,and there was a risk of placental abruption when the serum concentration was >95.17 U/ml.The area under the curve of serum MMP-9 was 0.882,the sensitivity was 89.0%,the specificity was 90.6%,and there was a risk of placental abruption when the serum concentration was <121.21 ng/ml.The area under the curve of their combination was 0.965,the sensitivity was 93.4%,the specificity was 90.5%,and there was a risk of placental abruption when the the Pre-1 was >0.534.Conclusion:The combined detection of serum CA125 and MMP-9 has a certain clinical value in predicting placental abruption and is helpful to improve the accuracy and scientificity of diagnosis.