發(fā)布時間：2018-07-10 00:06

  本文選題：子癇前期 + 平均動脈壓�。� 參考：《中國婦產(chǎn)科臨床雜志》2017年03期

【摘要】：目的探討中孕早期聯(lián)合母體特征、平均動脈壓(MAP)及血清學標記物預測子癇前期(PE)的價值。方法前瞻性留取2014年5月至2015年5月孕婦行中期唐氏篩查時的血樣,追蹤妊娠結(jié)局,獲取重癥子癇前期(SPE)31例,非重癥子癇前期(Non-SPE)29例,妊高(GH)35例和正常妊娠(NP)120例,比較疾病組和對照組的母體特征,MAP及7項血清學指標。應用Logistic和ROC曲線分析各指標單獨或聯(lián)合時預測PE的敏感度和特異度,構(gòu)建預測PE的最優(yōu)模型。結(jié)果 (1)與NP組比較,SPE組的母齡、Non-SPE和GH組的BMI明顯增大(均P0.01);(2)PE和GH組的MAP均明顯升高,且在SPE組中升高最為顯著(均P0.01);PE組的Pl GF和PAPP-A水平較NP組均明顯降低(均P0.01),h CG水平僅在SPE組中顯著上升(P0.01);PE組中PP13、s Flt-1、s Eng和VEGF水平與NP組比較,差別均無明顯統(tǒng)計學意義。GH組的各項血清學指標水平較NP組均無明顯差別;(3)Logistic回歸示SPE的最佳預測模型為:母齡聯(lián)合MAP、PAPP-A、Pl GF和HCG,AUC達0.924(95%CI:0.870~0.961;P0.01),敏感度和特異度分別為94%和78%;Non-SPE的最佳預測模型為:BMI聯(lián)合MAP、PAPP-A和Pl GF,AUC達0.877(95%CI:0.813~0.925;P0.01),敏感度和特異度分別為86%和74%。結(jié)論中孕早期聯(lián)合母體特征、MAP及母體血清學指標PAPP-A、Pl GF、h CG的水平變化能提高PE的檢出率,且有助于評估其嚴重程度。
[Abstract]:Objective to investigate the value of combined maternal characteristics, mean arterial pressure (map) and serological markers in predicting preeclampsia (PE). Methods Blood samples were collected from pregnant women who underwent Down's screening from May 2014 to May 2015. The pregnancy outcome was followed up. 31 cases of severe preeclampsia (SPE), 29 cases of non-severe preeclampsia (Non-SPE), 35 cases of pregnancy induced hypertension (GH) and 120 cases of normal pregnancy (NP) were obtained. Map and 7 serological indexes were compared between the disease group and the control group. Logistic and ROC curves were used to analyze the sensitivity and specificity of each index in predicting PE separately or jointly, and the optimal model for PE prediction was constructed. Results (1) compared with NP group, the maternal age non-SPE and GH group were significantly increased (P0.01); (_ 2). Map of PE and GH groups were significantly higher than that of NP group. In SPE group, the levels of Pl GF and PAPP-A in PE group were significantly lower than those in NP group (P 0.01). The levels of P1GF and PAPP-A in SPE group were significantly higher than those in NP group (P0.01), and the levels of PP13s Flt-1s Eng and VEGF in PE group were significantly higher than those in NP group. There was no significant difference between GH group and NP group. (3) Logistic regression showed that the best predictive model of SPE was: maternal age combined with MAPP-AAPP-Pl GF and HCGG AUC of 0.924 (95CI 0.870 0.961P0.01), sensitivity and specificity were 94% and 78 Non-SPE, respectively. The best predictive model was: 1: BMI combined with MAPPAPP-A and Pl GFAUC 0.877 (95 CI: 0.813 0. 925 P0.01), sensitivity and specificity were 86% and 74%, respectively. Conclusion the changes of map and PAPP-A1GFhCG in early pregnancy can increase the detection rate of PE and help to evaluate the severity of PE.
【作者單位】： 北京大學深圳醫(yī)院婦產(chǎn)科北京大學深圳醫(yī)院女性重大疾病早期診斷技術(shù)重點實驗室;
【基金】：深圳市知識創(chuàng)新計劃基礎研究項目(20130319184850)
【分類號】：R714.244

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