CAJ | 학술논문

目的：探讨三维彩色能量超声（3D-CPA）检测胎盘组织血流灌注联合检测孕妇血浆中u-maspin基因含量以监测子痫前期患者风险的临床价值。方法正常晚期妊娠者15例为对照组，子痫前期轻度组18例，子痫前期重度组22例，对孕妇胎盘床血管进行三维重建，Vocal软件测量血管化指数（VI）、血流指数（FI）、血管化血流指数（VFI）。抽取孕妇血浆，应用甲基特异性PCR的原理及荧光定量PCR的方法，相对定量法检测u-maspin基因的含量。结果子痫前期轻度和重度组的VI、FI、VFI较对照组减小，子痫前期重度组的VI、FI、VFI较子痫前期轻度组减小（均P＜0．01）。40例子痫前期患者均检出u-maspin基因，u-maspin基因含量子痫前期轻度组是对照组的2．39倍，子痫前期重度组是对照组的5．78倍。结论3D-CPA可更早更精确地提示子痫前期患者的胎盘血流灌注情况，孕妇外周血中u-maspin基因含量能够反映子痫前期患病的严重程度，二者结合可以更好监测子痫前期患者风险，指导临床。
목적：탐토삼유채색능량초성（3D-CPA）검측태반조직혈류관주연합검측잉부혈장중u-maspin기인함량이감측자간전기환자풍험적림상개치。방법정상만기임신자15례위대조조，자간전기경도조18례，자간전기중도조22례，대잉부태반상혈관진행삼유중건，Vocal연건측량혈관화지수（VI）、혈류지수（FI）、혈관화혈류지수（VFI）。추취잉부혈장，응용갑기특이성PCR적원리급형광정량PCR적방법，상대정량법검측u-maspin기인적함량。결과자간전기경도화중도조적VI、FI、VFI교대조조감소，자간전기중도조적VI、FI、VFI교자간전기경도조감소（균P＜0．01）。40례자간전기환자균검출u-maspin기인，u-maspin기인함양자간전기경도조시대조조적2．39배，자간전기중도조시대조조적5．78배。결론3D-CPA가경조경정학지제시자간전기환자적태반혈류관주정황，잉부외주혈중u-maspin기인함량능구반영자간전기환병적엄중정도，이자결합가이경호감측자간전기환자풍험，지도림상。
Objective To explore the clinic value of monitoring the risk of preeclampsia using three-dimensional color power Doppler ultrasound (3D-CPA) which investigates the placenta blood perfusion and u-maspin gene of cell-free fetal DNA in maternal plasma. Methods Fifteen cases of normal pregnancy were in control group,18 cases of mild preeclampsia were in mild preeclampsia group,22 cases of severe preeclampsia were in severe preeclampsia group. Three-dimensional reconstruction of placental vascular was performed,and placental vascularization index (VI),flow index (FI),and vascularization-flow index (VFI) were measured using VOCAL software. Maternal plasma was extracted,and u-maspin gene was detected using fluorescent quantitative methylation-specific PCR. Results VI,FI and VFI decreased in mild preeclampsia group and severe preeclampsia group compared with control group(P<0.01),and they were the lowest in severe preeclampsia group(P<0.01). U-maspin gene detected was positive in all 40 cases of preeclampsia the concentration of which in mild preeclampsia group was 2. 39 times of that in control group and severe preeclampsia group was 5. 78 times. Conclusion 3D-CPA could show placental perfusion in patients with preeclampsia earlier and more accurately. U-maspin gene can reflects the severity of the preeclampsia. The combination of 3D-CPA and u-maspin gene can monitor risk of patients with preeclampsia and direct clinic.