中孕早期子痫前期联合预测指标的价值

发布时间：2018-07-10 00:06

本文选题：子痫前期 + 平均动脉压　；参考：《中国妇产科临床杂志》2017年03期

【摘要】：目的探讨中孕早期联合母体特征、平均动脉压(MAP)及血清学标记物预测子痫前期(PE)的价值。方法前瞻性留取2014年5月至2015年5月孕妇行中期唐氏筛查时的血样,追踪妊娠结局,获取重症子痫前期(SPE)31例,非重症子痫前期(Non-SPE)29例,妊高(GH)35例和正常妊娠(NP)120例,比较疾病组和对照组的母体特征,MAP及7项血清学指标。应用Logistic和ROC曲线分析各指标单独或联合时预测PE的敏感度和特异度,构建预测PE的最优模型。结果 (1)与NP组比较,SPE组的母龄、Non-SPE和GH组的BMI明显增大(均P0.01);(2)PE和GH组的MAP均明显升高,且在SPE组中升高最为显著(均P0.01);PE组的Pl GF和PAPP-A水平较NP组均明显降低(均P0.01),h CG水平仅在SPE组中显著上升(P0.01);PE组中PP13、s Flt-1、s Eng和VEGF水平与NP组比较,差别均无明显统计学意义。GH组的各项血清学指标水平较NP组均无明显差别;(3)Logistic回归示SPE的最佳预测模型为:母龄联合MAP、PAPP-A、Pl GF和HCG,AUC达0.924(95%CI:0.870~0.961;P0.01),敏感度和特异度分别为94%和78%;Non-SPE的最佳预测模型为:BMI联合MAP、PAPP-A和Pl GF,AUC达0.877(95%CI:0.813~0.925;P0.01),敏感度和特异度分别为86%和74%。结论中孕早期联合母体特征、MAP及母体血清学指标PAPP-A、Pl GF、h CG的水平变化能提高PE的检出率,且有助于评估其严重程度。
[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.
【作者单位】：北京大学深圳医院妇产科北京大学深圳医院女性重大疾病早期诊断技术重点实验室;
【基金】：深圳市知识创新计划基础研究项目(20130319184850)
【分类号】：R714.244

【相似文献】