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目的探究唐氏筛查血清标志物水平与子痫前期(preeclampsia,PE)及胎儿生长受限(fetal growth restriction,FGR)发病的相关性,了解妊娠中期血清绒毛膜促性腺激素β亚单位(freeβ-human chorionic gonadotropin,β-hCG)、甲胎蛋白(alpha fetoprotein,AFP)及游离雌三醇(unconjugated estriol,uE_3)三种因子单独及联合对PE及FGR发病的预测价值。方法回顾性分析本院2013年4月至2015年10月妊娠16~20周PE(PE组)和FGR(FGR组)及正常妊娠(对照组)血清β-hCG、AFP及uE_3临床资料,应用工作者曲线(ROC曲线下面积AUC)及约登指数评判各血清指标预测PE及FGR的价值,并确定相应的预测界值。结果 PE组uE_3水平明显高于对照组(P<0.05);FGR组β-hCG水平明显高于对照组(P<0.05)。AFP、uE_3及β-hCG三者联合预测PE和FGR的AUC值分别为0.621和0.622;而三种因子分别预测PE的AUC值分别是0.456、0.376和0.547;预测FGR的AUC分别为0.610、0.377和0.495。结论妊娠中期β-hCG、AFP及uE_3指标均无较好地预测PE和FGR的价值,但是三种因子联合优于单独的预测价值。
Objective To investigate the relationship between Down’s screening serum markers and the incidence of preeclampsia (PE) and fetal growth restriction (FGR), and to understand the relationship between serum free chorionic gonadotrophin beta subunit β-hCG), alpha fetoprotein (AFP) and unconjugated estriol (uE_3) alone and in combination on the predictive value of the pathogenesis of PE and FGR. Methods The clinical data of β-hCG, AFP and uE_3 in PE (PE group), FGR group (FGR group) and normal pregnancy (control group) from April 2013 to October 2015 in our hospital from April 2013 to October 2015 were retrospectively analyzed. The curves of workers (area under the ROC curve AUC) and the Youden index were used to evaluate the predictive value of PE and FGR for each serum index, and the corresponding predictive value was determined. Results The level of uE_3 in PE group was significantly higher than that in control group (P <0.05). The level of β-hCG in FGR group was significantly higher than that in control group (P <0.05). The AUC values of AFP, uE_3 and β-hCG were 0.621 and 0.622, respectively. The AUC of PE and FGR were 0.456,0.376 and 0.547, respectively. The AUC of FGR was 0.610 and 0.377 respectively And 0.495. Conclusion The β-hCG, AFP and uE_3 indexes in the second trimester of pregnancy are not good predictors of the value of PE and FGR, but the combination of three factors is better than the single predictive value.