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目的 :研究妊娠相关血浆蛋白A(PAPP A)在本地区正常妊娠孕妇血清中的变化以及对高危妊娠的早期诊断和监测的价值。方法 :采用ELISA定量检测法 ,对 2 189例孕妇血清中PAPP A进行了检测 ,其中正常妊娠组 2 115例 ,流产及先兆流产组 2 3例 ,妊高症组 39例 ,胎儿畸形组 12例。结果 :正常妊娠孕妇血清中PAPP A含量随孕龄的进展稳定增加 ,直至妊娠晚期。难免流产患者 85 70 %的血清PAPP A接近或低于正常值的下限 ;胎儿畸形组有 41.6 7%的血清PAPP A接近或低于正常值的下限 ;而轻、中度妊高征患者有 73 .5 0 % ,重度妊高征患者有 6 0 .0 0 %的血清PAAP A在正常均值以上。结论 :孕妇血清PAPP A的检测在预报难免流产方面有较高的准确性 ,在筛查胎儿畸形及妊高征等高危妊娠的监测方面也具有较大的临床价值。
Objective: To investigate the changes of serum PAPP A in serum of normal pregnant women in this region and the value of early diagnosis and monitoring of high-risk pregnancy. Methods: Serum PAPP A was detected by ELISA in 2 189 pregnant women, including 2115 cases of normal pregnancy, 23 cases of abortion and threatened abortion, 39 cases of pregnancy-induced hypertension and 12 cases of fetal malformation . Results: The content of PAPP A in normal pregnant women increased steadily with gestational age until the third trimester of pregnancy. It is difficult to avoid miscarriage 85 70% of the serum PAPP A close to or lower than the lower limit of normal; fetal abnormalities group 41.6 7% of the serum PAPP A close to or lower than the lower limit of normal; and mild and moderate pregnancy-induced hypertension 73 .5 0%, 60% of patients with severe PIH had PAAP A above the normal mean value of 60%. Conclusion: The detection of serum PAPP A in pregnant women has a higher accuracy in predicting unavoidable abortion. It also has great clinical value in screening high-risk pregnancies such as fetal malformation and pregnancy-induced hypertension.