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目的探讨孕早期血清妊娠相关蛋白-A(PAPP-A)和血清金属蛋白酶12(ADAM12)-S水平变化及其与胚停育的相关性。方法回顾性分析2007年6月至2009年6月就诊于温州市第二人民医院788例孕早期(6～13周)孕妇,应用全自动时间分辨荧光免疫分析法测定其血清中PAPP-A和ADAM12-S水平,并对测定结果及结局进行分析。结果 (1)孕6、7、8、9、10、11、12、13周孕妇血清PAPP-A的中位数分别为93.19、222.56、438.63、790.56、1388.98、2440.99、3266.46、4031.83mU/L。血清PAPP-A水平呈现出随孕周增加而逐渐上升的趋势,呈线型相关(r=0.964,P<0.05)。(2)孕6、7、8、9、10、11、12、13周孕妇血清ADAM12-S中位数分别为60.08、114.13、222.12、295.29、378.11、435.66、500.93、564.95μg/L。孕妇血清ADAM12-A的水平呈现出随孕周增加而逐渐上升趋势,呈线型相关(r=0.997,P<0.05)。(3)妊娠早期孕妇的血清PAPP-A水平与ADAM12-S的水平呈正相关(r=0.793,P<0.05)。(4)788例中正常单胎孕妇657例,胚胎停止发育者75例,胚停育者血清PAPP-A及ADAM12-S水平明显低于同孕周正常早孕妇女,两组间差异有统计学意义(P<0.05)。结论孕早期孕妇血清PAPP-A和ADAM12-S水平随孕周增加而上升,可能是预测胚胎停止发育的指标。
Objective To investigate the changes of serum level of pregnancy-associated protein-A (PAPP-A) and serum level of metalloproteinase-12 (ADAM12) -S in early pregnancy and its relationship with embryo development. Methods A retrospective analysis of 788 pregnant women (6 ~ 13 weeks) from July 2007 to June 2009 in Wenzhou Second People’s Hospital was performed. The levels of PAPP-A in serum were determined by automatic time-resolved fluorescence immunoassay ADAM12-S levels, and analysis of the results and outcome. Results (1) Median PAPP-A in pregnant women at 6, 7, 8, 9, 10, 11, 12 and 13 weeks pregnant were 93.19,222.56,438.63,790.56,1388.98,2440.99,3266.46,4031.83mU / L . Serum PAPP-A showed a trend of rising gradually with the increase of gestational age, which showed a linear correlation (r = 0.964, P <0.05). (2) The median ADAM12-S serum levels of pregnant women at 6th, 7th, 8th, 9th, 10th, 11th, 12th and 13th weeks of pregnancy were 60.08,114.13,222.12,295.29,378.11,435.66,500.93,564.95μg / L, respectively. The serum level of ADAM12-A in pregnant women showed a trend of rising gradually with the increase of gestational age and was linearly related (r = 0.997, P <0.05). (3) Serum PAPP-A level of pregnant women in early pregnancy positively correlated with the level of ADAM12-S (r = 0.793, P <0.05). (4) There were 657 normal singleton pregnant women in 788 cases and 75 cases of embryo stop development. The levels of serum PAPP-A and ADAM12-S in embryo stoppers were significantly lower than those in normal pregnant women with normal gestational weeks. The differences between the two groups were statistically significant Significance (P <0.05). Conclusion The serum levels of PAPP-A and ADAM12-S in pregnant women during the first trimester may increase with the increase of gestational age, which may be an indicator of predicting the stop development of embryos.