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目的探讨孕早期标志物胎盘生长因子(PlG F)、妊娠相关蛋白A(PAPP-A)、平均动脉压(MAP)、身体质量指数(BMI)单独或联合模式对重度子痫前期(sP E)的预测价值。方法采用前瞻性巢氏病例对照研究方法,选取2010年7月-2013年5月在该院产科例行唐氏筛查的10~13+6周孕妇为研究对象,收集其血清并追踪至分娩,根据随后是否发展为sP E,分为疾病组(34例)和对照组(178例)。检测两组PlG F、PAPP-A、抑制素A(INH-A)水平,计算两组MAP和BMI。比较上述孕早期标志物在两组中的差异,对差异有统计学意义的标志物进行Logistic回归分析并分析其预测价值。结果早期BMI、MAP与sP E呈正相关(P<0.05),PlG F和PAPP-A与sP E呈负相关(P<0.05)。具有预测价值的单个标志物依次是PlG F、BMI、MAP、PAPP-A。预测价值最大的联合标志物是PAPP-A+PlG F+MAP+BMI(AUC~(ROC)=0.841),其次是PAPP-A+PlG F+MAP(AUC~(ROC)=0.826)。结论早期血清PlG F、BMI、MAP、PAPP-A可预测随后发生的sP E,多标志物联合预测价值明显增加。
Objective To investigate the effects of placental growth factor (PlG F), PAPP-A, MAP and BMI alone or in combination on early stage of severe preeclampsia (sP E) The predictive value. Methods A prospective case-control study was conducted to select 10 ~ 13 + 6 weeks pregnant women who underwent Down’s maternity screening from July 2010 to May 2013 in our hospital. The sera were collected and traced until delivery Patients were divided into disease group (34 cases) and control group (178 cases) according to whether they were subsequently developed into sEP. The levels of PlG F, PAPP-A and INH-A in both groups were detected, and MAP and BMI were calculated. The differences of the above-mentioned early pregnancy markers in the two groups were compared. Logistic regression analysis was used to analyze the predictive value of the markers with statistical significance. Results Early BMI, MAP and sP E were positively correlated (P <0.05). PlG F and PAPP-A were negatively correlated with sP E (P <0.05). The single marker with predictive value followed by PlG F, BMI, MAP, PAPP-A. The combined markers with the highest predictive value were PAPP-A + PlG F + MAP + BMI (AUC ROC) = 0.841), followed by PAPP-A + PlG F + MAP (AUC ROC = 0.826). Conclusion The early serum PlG F, BMI, MAP, PAPP-A can predict the subsequent occurrence of sP E, the combined value of multiple markers significantly increased.