血清PAPP-A与子宫动脉超声多普勒血流参数的关系及其对早发型子痫前期的预测价值OACSTPCD
Relationship between serum PAPP-A and uterine artery ultrasound Doppler blood flow parameters and its predictive value for early onset preeclampsia
目的 探讨血清妊娠相关血浆蛋白A(PAPP-A)与子宫动脉超声多普勒血流参数的关系及对早发型子痫前期(E-PE)的预测价值.方法 选取2020年1月至2023年2月该院收治的132例E-PE患者作为E-PE组.另选取同期该院75例健康孕妇作为对照组.采用酶联免疫吸附试验检测2组血清PAPP-A水平,检测并比较子宫动脉血流参数[搏动指数(PI)、阻力指数(RI)、子宫动脉收缩期和舒张期血流速度比值(S/D)].采用多因素Logistic回归分析E-PE发生的危险因素.采用Pearson相关分析血清PAPP-A水平与RI、PI和S/D的相关性.绘制受试者工作特征(ROC)曲线,分析血清PAPP-A与子宫动脉血流参数单独及联合检测对E-PE发生的预测价值.结果 E-PE组血清PAPP-A水平明显低于对照组,RI、PI和S/D均明显高于对照组,差异均有统计学意义(P＜0.05).血清PAPP-A水平与RI、PI和S/D均呈负相关(r=-0.446、-0.366、-0.524,P＜0.001).多因素 Logistic 回归分析结果显示,血清 PAPP-A(OR=0.582,95％CI:0.461～0.734)水平降低、RI(OR=1.831,95％CI:1.235～2.715)升高、PI(OR=1.865,95％CI:1.195～2.909)升高和 S/D(OR=2.016,95％CI:1.091～3.723)升高是E-PE发生的危险因素(P＜0.05).ROC曲线分析结果显示,血清PAPP-A、RI、PI、S/D单独检测预测E-PE发生的AUC分别为0.804、0.763、0.624、0.710,均小于4项指标联合检测预测E-PE发生的AUC(P＜0.05).结论 E-PE患者血清PAPP-A和子宫动脉超声多普勒血流参数异常,PAPP-A水平与血流参数呈负相关,可应用于E-PE的预测,值得临床进一步研究并推广.
Objective To investigate the relationship between serum pregnancy-associated plasma protein-A(PAPP-A)and uterine artery Doppler blood flow parameters and its predictive value of early onset pre-eclampsia(E-PE).Methods A total of 132 patients with E-PE admitted to the hospital from January 2020 to February 2023 were selected as the E-PE group.In addition,75 healthy pregnant women in the hospital during the same period were selected as the control group.The level of serum PAPP-A in the two groups was detec-ted by enzyme-linked immunosorbent assay,and the uterine artery blood flow parameters[pulsatility index(PI),resistance index(RI),and the ratio of uterine artery systolic and diastolic blood flow velocity(S/D)]were detected and compared.Multivariate Logistic regression was used to analyze the risk factors of E-PE.Pearson correlation analysis was used to analyze the correlation between serum PAPP-A and RI,PI and S/D.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of PAPP-A and uterine artery blood flow parameters alone or in combination for the occurrence of E-PE.Results The serum PAPP-A level of the E-PE group was significantly lower than that of the control group,and RI,PI and S/D were significantly higher than those of the control group,and the differences were statistically significant(P＜0.05).Serum PAPP-A was negatively correlated with RI,PI and S/D(r=-0.446,-0.366,-0.524,P＜0.001).Multivariate Logistic regression analysis showed that decreased serum PAPP-A(OR=0.582,95％CI:0.461-0.734)level,increased RI(OR=1.831,95％CI:1.235-2.715),increased PI(OR=1.865,95％CI:1.195-2.909),and increased S/D(OR=2.016,95％CI:1.091-3.723)were the risk factors for E-PE(P＜0.05).The results of ROC curve analysis showed that AUC of serum PAPP-A,RI,PI and S/D in predic-ting the occurrence of E-PE were 0.804,0.763,0.624 and 0.710 respectively,which were smaller than the AUC of combined detection of the four indicators(P＜0.05).Conclusion Serum PAPP-A and uterine artery Doppler blood flow parameters are abnormal in patients with E-PE,PAPP-A is negatively correlated with blood flow parameters.They can be applied to the prediction of E-PE,which is worthy of further clinical re-search and promotion.
成云云;王茹;张凯
河北省邢台市第三医院 产二科,河北邢台 054000||河北省邢台市第三医院 检验科,河北邢台 054000
临床医学
妊娠相关血浆蛋白A子宫动脉血流参数早发型子痫前期相关性预测效能
pregnancy-associated plasma protein-Auterine artery blood flow parameterearly-onset preeclampsiacorrelationprediction efficiency
《检验医学与临床》 2024 (014)
2030-2033 / 4
河北省邢台市重点研发计划项目(2022ZC231).
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