血清妊娠相关血浆蛋白A在诊断异常妊娠中的临床意义

目的:探讨血清妊娠相关血浆蛋白A(PAPP-A)在诊断异常妊娠中的临床意义,分析其与异常妊振的关系。方法:选取299例5~13周的正常早孕妇为正常早孕组,同期选取稽留流产86例,先兆流产54例,异位妊娠76例为异常妊娠组,用酶联免疫吸附试验(ELASA)测定两组受试者的血清PAPP-A水平,分析两组受试者各个孕周内的血清PAPP-A水平的差异。结果:稽留流产孕妇在各个孕周内(9~13周)的血清PAPP-A水平显著低于同孕周内正常早孕孕妇(t值分别为9.500,8.113,3.511,9.538,8.504,P值均0.05);稽留流产孕妇总的平均血清PAPP-A水平亦低于常早孕孕妇(t=3.651,P值均0.05);异位妊娠孕妇在各个孕周内(9~13周)的血清PAPP-A水平显著低于同孕周内正常早孕孕妇(t值分别为7.976,9.030,9.941,11.625,14.079,12.569,P值均0.05),异位妊娠孕妇总的平均血清PAPP-A水平亦低于常早孕孕妇(t=28.168,P值均0.05);先兆流产孕妇(除孕8周)与正常早孕妊娠血清PAPP-A水平比较无显著统计学意义。结论:血清PAPP-A水平在异常妊娠如异位妊娠、稽留流产中显著降低,可作为诊断异位妊娠、稽留流产及先兆流产辅助诊断的生物学指标。

Clinical Significance of SerumPregnancy Associated Plasma Protein A in the Diagnosis of Abnormal Pregnancy

Objective:To investigate the clinical significance of serum pregnancy associated plasma proteinA (PAPP-a) in the diagnosis of abnormal pregnancy, and to analyze its relationship with abnormal pregnancy.Methods:The 299 cases of normal early pregnant women of 5 ~ 13 weeks were selected as normal pregnancy group. At the same time, 86 cases of missed abortion, 54 cases of threatened abortion and 76 cases of ectopic pregnancy were chosen as abnormal pregnancy group. Enzyme linked immunosorbent test (ELASA) was applied for determination of serum PAPP-A levels of the two groups. The serum PAPP -A level difference at each pregnancy week of subjects were compared and analyzed between the two groups.Results:The serum PAPP-A levels of missed abortion cases in different pregnant weeks (9 ~ 13 weeks) were significantly lower than those of normal pregnant women at the same weeks (t value were respectively 9.500, 8.113, 3.511, 9.538, 8.504, P values < 0.05). The general average serum PAPP-A level was also lower in the women of missed abortion than in normal pregnant women (t = 3.651, P < 0.05). The serum PAPP-A levels of different weeks (9 ~ 13 weeks) were also significantly lower in ectopic pregnant women than in normal early pregnant women at the same week (t value were 7.976, 9.030, 9.941, 11.625, 14.079, 12.569, P values < 0.05). The general average PAPP-A level was also lower in the ectopic pregnant women than in the normal early pregnant women (t = 28.168, P < 0.05); Threatened abortion women (except at 8 weeks) had no statistical difference in serum PAPP-A level with the normal pregnant women.Conclusion:Serum PAPP-A level reduced significantly in abnormal pregnancy such as heterotopic pregnancy and missed abortion. It can be used as a biological indicator for diagnosis of ectopic pregnancy, missed abortion and auxiliary diagnosis of threatened abortion.