妊娠早中期孕妇血清中甲胎蛋白、游离雌三醇、抑制素A及子宫动脉搏动指数预测子痫前期的价值

王朝; 罗大江; 唐龙英

doi:10.13898/j.cnki.issn.1000-2200.2021.06.007

妊娠早中期孕妇血清中甲胎蛋白、游离雌三醇、抑制素A及子宫动脉搏动指数预测子痫前期的价值

The value of the levels of alpha-fetoprotein, free estriol, inhibin A and uterine arterial pulse index in predicting preeclampsia of pregnant women in the first and second trimesters of pregnancy

摘要

摘要:
目的探讨妊娠早中期孕妇血清中甲胎蛋白（AFP）、游离雌三醇（uE3）、抑制素A（InhA）及子宫动脉搏动指数（PI）单独和联合预测子痫前期的价值。
方法选择产检的单胎初孕产妇1 000例，其中随访至产后3个月的有945例。将945例孕妇中诊断为子痫前期的孕妇作为病例组，在未发生子痫前期的孕妇中按1∶4的比例为病例组匹配对照组。检测并记录妊娠早中期孕妇血清中的AFP、uE3、InhA和PI。
结果945例孕妇子痫前期的发病率为3.5%（33/945）。病例组和对照组孕妇AFP差异无统计学意义（P>0.05），病例组孕妇InhA和PI高于对照组孕妇，uE3低于对照组孕妇，差异均有统计学意义（P<0.05~P<0.01）。InhA、uE3和PI预测子痫前期的灵敏度分别为48.4%、72.7%和57.6%，InhA、uE3和PI预测子痫前期的特异度分别为78.0%、69.7%和84.8%；联合指标预测子痫前期的灵敏度和特异度分别为75.8%和76.5%；ROC曲线下面积为0.825，大于InhA、uE3和PI值3个单项指标的ROC曲线下面积（P<0.01）。
结论妊娠早中期孕妇血清中的uE3、InhA和PI联合预测和诊断子痫前期的价值相对单个指标较好。

Abstract:
ObjectiveTo analyze the value of the individual and combined the levels of alpha-fetoprotein(AFP), free estriol(uE3), inhibin A(InhA) and uterine arterial pulse index(PI) in predicting preeclampsia of pregnant women in the first and second trimesters of pregnancy.
MethodsA total of 1 000 singleton primiparas were selected, 945 pregnant women diagnosed by preeclampsia were set as the case group, and the case group was matched to the control group in a ratio of 1:4 among pregnant women without preeclampsia.The serim levels of AFP, uE3 and InhA, and PI were detected and recorded.
ResultsThe incidence rate of preeclampsia in 945 pregnant women was 3.5%(33/945).There was no statistical significance in the AFP level between two group(P>0.05).The value of InhA and PI in case group were higher than those in control group, and the uE3 value in case group was lower than that in control group(P<0.05 to P<0.01).The sensitivities of InhA, uE3 and PI in predicting preeclampsia of pregnant women were 48.4%, 72.7% and 57.6%, respectively.The specificities of InhA, uE3 and PI in predicting preeclampsia of pregnant women were 78.0%, 69.7% and 84.8%, respectively.The sensitivity and specificity of the combined index for predicting preeclampsia were 75.8% and 76.5%, respectively.The area under the ROC curve of the combined data in predicting preeclampsia was 0.825, which was significantly higher than that of InhA, uE3 and PI, respectively(P<0.05).
ConclusionsThe combined value of uE3, InhA and PI in predicting preeclampsia is better than that of single parameter in the first and second trimesters of pregnancy.

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