子痫前期患者血清妊娠相关血浆蛋白A和同型半胱氨酸表达对妊娠结局的影响OACSTPCD

Objective To investigate the impacts of serum pregnancy associated plasma protein A(PAPP-A)and homo-cysteine(Hcy)expression on pregnancy outcomes in patients with preeclampsia(PE).Methods A total of 128 PE patients who underwent prenatal examination and delivery in our hospital from January 2020 to January 2023 were collected as the research sub-jects,enzyme linked immunosorbent assay(ELISA)was applied to detect the expression levels of PAPP-A and Hcy in pregnant women's serum before delivery.According to pregnancy outcomes,patients were grouped into a good outcome group and a poor out-come group.Logistic regression was applied to analyze the influencing factors of adverse pregnancy outcomes in PE patients.ROC curve was applied to analyze the predictive efficacy of serum PAPP-A and Hcy expression levels in PE patients on adverse pregnan-cy outcomes.Results The incidence of adverse pregnancy outcomes in 128 PE patients was 27.34%(35/128).The serum PAPP-A level in poor outcome group was lower than that in the good outcomes group(P＜0.05),while the Hcy level was higher than that in the good outcomes group(P＜0.05).The gestational age at delivery and platelet count of patients in the poor outcome group were lower than those in the good outcome group(P＜0.05),the proportions of patients with severe PE and early-onset PE were higher than those in the good outcomes group(P＜0.05).The results of Logistic regression analysis showed that severe PE,early onset PE,and high expression of Hcy were all risk factors for poor pregnancy outcomes in PE patients(P＜0.05),while platelet count and high expression of PAPP-A were protective factors(P＜0.05).The ROC analysis results showed that the area under the curve(AUC)of the combined prediction of serum PAPP-A and Hcy levels in PE patients for adverse pregnancy outcomes was 0.913,which was higher than the AUC predicted by PAPP-A alone(Z =2.415,P =0.016)and the AUC predicted by Hcy a-lone(Z =2.416,P =0.016).Conclusion The Hcy level in patients with poor pregnancy outcomes is up-regulated,while PAPP-A level is down-regulated.Both have predictive value for pregnancy outcomes in PE patients,and the combined prediction of the two is more effective.