妊娠11～14周孕妇血清PAPP-A与血清CA125、TM联合检测在早期诊断胎盘早剥中的价值

发布时间：2019-07-18 13:34

【摘要】：目的探讨妊娠11~14周孕妇血清中PAPP-A水平值在胎盘早剥中的预测价值,以及联合检测孕妇血清中CA125、TM水平对早期诊断胎盘早剥的临床价值。方法前瞻性选取2014年1月到2015年8月,孕11~14周时行Ⅰ期唐氏筛查的孕妇,孕周大于20周后有阴道出血、子宫体压痛、腰背痛、不明原因胎儿窘迫及宫缩过频、子宫张力过高等怀疑胎盘早剥的孕妇100例作为研究对象,产后检查是否有胎盘早剥再分为早剥组66例、无早剥组34例;同期选择在该院产检并正常分娩的100例孕妇为对照组,分别登记其PAPP-A值,并行CA125、TM检测,B超检查和产后胎盘检查,比较三组检测结果的差异。应用ROC曲线和约登指数评判各血清学指标在胎盘早剥诊断中的价值,并确定PAPP-A和TM相应的诊断界值。结果妊娠11~14周血清PAPP-A值,胎盘早剥组明显低于无胎盘早剥组和正常对照组(P0.05),胎盘早剥组CA-125、TM水平明显高于无胎盘早剥组和正常对照组,均有统计学意义(P0.05)。将PAPP-A、TM作为检验变量得出诊断胎盘早剥的界值,PAPP-A2 028 m U/L、TM55μg/L时预测价值最高。结论妊娠11~14周低水平的血清PAPP-A值对胎盘早剥有预测作用;高水平的血清CA-125和高TM值对胎盘早剥的早期诊断具有较高的临床应用价值。
[Abstract]:Objective to investigate the predictive value of serum PAPP-A level in placental abruption and the clinical value of combined detection of serum CA125,TM level in early diagnosis of placental abruption. Methods from January 2014 to August 2015, 100 pregnant women with suspected placental abruption, such as vaginal bleeding, uterine tenderness, low back pain, unexplained fetal distress, uterine contraction frequency and uterine tension, were selected as subjects. 66 pregnant women with placental abruption were divided into early stripping group (n = 66) and no abruption group (n = 34). At the same time, 100 pregnant women who underwent antenatal examination and normal delivery in our hospital were selected as the control group. The PAPP-A value, CA125,TM test, B-ultrasound examination and postpartum placental examination were registered respectively, and the differences among the three groups were compared. ROC curve and Jordan index were used to evaluate the value of each serological index in the diagnosis of placental abruption, and the corresponding diagnostic bounds of PAPP-A and TM were determined. Results the serum PAPP-A level in the placental early denudation group was significantly lower than that in the non-placental early exudation group and the normal control group (P 0.05). The CA-125,TM level in the placental early exudation group was significantly higher than that in the non placental early denudation group and the normal control group (P 0.05). PAPP-A,TM was used as a test variable to obtain the boundary value for the diagnosis of placental abruption. The predictive value of PAPP-A2 0.28 mu / L and TM 55 渭 g / L was the highest. Conclusion the low level of serum PAPP-A at the end of 11 weeks of gestation has a predictive effect on placental abruption, and the high level of serum CA-125 and TM have high clinical value in the early diagnosis of placental abruption.
【作者单位】：广东药学院附属第二医院广州新海医院妇产科;
【基金】：广东省医学科学技术研究基金项目(B2015098)
【分类号】：R714.2

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