孕妇血清PAPP-A、AFP、freeβ-HCG检测在爱德华氏综合征筛查中的应用价值研究

Application value of serum PAPP-A,AFP and free beta-HCG in screening for Edward′s syndrome in pregnant women

目的研究爱德华氏综合征筛查中孕妇血清妊娠相关蛋白A(PregnancyAssociatedPlasmaProtein A,PAPP-A)、甲胎蛋白(AlphaFetoprotein,AFP)、游离人促绒毛膜性腺激素β(Free-β-HumanChorionic Gonadotropin,freeβ-HCG)检测的应用价值。方法选取我院2017年6月~2018年12月羊水穿刺确诊的55例爱德华氏综合征孕妇为观察组,另选同期产检的55例健康孕妇作为对照组,对两组血清PAPP-A、AFP、freeβ-HCG检测结果进行对比并研究血清PAPP-A、AFP、freeβ-HCG及三者联合检测在爱德华氏综合征筛查中的应用价值。结果观察组血清PAPP-A低于对照组,AFP、freeβ-HCG高于对照组,差异有统计学意义(P<0.05);以羊水穿刺结果为参照,血清PAPP-A、AFP、freeβ-HCG联合检测敏感度、特异度、阳性预测值、阴性预测值>两两指标联合检测>单一指标检测,差异有统计学意义(P<0.05)。结论爱德华氏综合征筛查中孕妇血清PAPP-A异常降低,而AFP、freeβ-HCG均呈升高态势,三者联合检测能够取得更为理想的筛查结果,值得加以推广使用。

Objective:To study the value of serum pregnancy-related protein A(PAPP-A),alpha-fetoprotein(AFP),free human chorionic gonadotropin(Free-beta-Human Chorionic Gonadotropin,free beta-HCG)in screening for Edward’s syndrome.Methods:55 pregnant women with Edward′s syndrome diagnosed by amniocentesis in our hospital from June 2017 to December 2018 were selected as observation group,and 55 healthy pregnant women in the same period were selected as control group.The results of serum PAPP-A,AFP and free beta-HCG were compared between the two groups,and the application value of serum PAPP-A,AFP,free beta-HCG and their combined detection in Edward′s syndrome screening was studied.Results:The serum PAPP-A of the observation group was lower than that of the control group,and AFP and free beta-HCG were higher than that of the control group(P<0.05).With amniocentesis as a reference,the sensitivity,specificity,positive predictive value and negative predictive value of the combined detection of serum PAPP-A,AFP and free beta-HCG were higher than that of the combined detection of two indicators>single indicator detection,and the difference was statistically significant(P<0.05).Conclusion:The abnormal decrease of PAPP-A in pregnant women′s serum during screening for Edward′s syndrome,and the increase of AFP and free beta-HCG.The combined detection of AFP and free beta-HCG can achieve better screening results,which is worth popularizing.