CAJ | 학술논문

目的：探讨联合检测早期孕妇血清中妊娠相关蛋白A （PA PP-A ）和抑制素A对先兆流产结局的预测价值。方法选择孕6～11周孕妇462人，随访至胎儿出生，其中由先兆流产发展为难免流产者43人（A组），由先兆流产经过治疗继续妊娠者52人（B组），正常妊娠者367人（C组）。分别采用时间分辨荧光免疫分析法和酶联免疫化学发光分析法检测各组血清 PA PP-A和抑制素A水平。结果 A组血清PAPP-A及抑制素A水平明显低于B组和C组，差异有统计学意义（P＜0．05）。B组血清PAPP-A及抑制素A的浓度低于C组，但差异无统计学意义（P＞0．05）。以98．12 mU/L作为临界值，PAPP-A预测难免流产的敏感性、特异性和准确性分别为85．6％、82．3％和82．6％。以231．47 pg/mL作为临界值，抑制素A预测难免流产的敏感性、特异性和准确性分别为85．2％、83．5％和86．3％。二者联合检测时，预测难免流产的敏感性、特异性和准确性分别为84．6％、86．6％和89．1％。结论 PA PP-A及抑制素A对先兆流产的结局具有一定的预测价值，二者联合检测可以提高诊断特异性和准确性。
목적：탐토연합검측조기잉부혈청중임신상관단백A （PA PP-A ）화억제소A대선조유산결국적예측개치。방법선택잉6～11주잉부462인，수방지태인출생，기중유선조유산발전위난면유산자43인（A조），유선조유산경과치료계속임신자52인（B조），정상임신자367인（C조）。분별채용시간분변형광면역분석법화매련면역화학발광분석법검측각조혈청 PA PP-A화억제소A수평。결과 A조혈청PAPP-A급억제소A수평명현저우B조화C조，차이유통계학의의（P＜0．05）。B조혈청PAPP-A급억제소A적농도저우C조，단차이무통계학의의（P＞0．05）。이98．12 mU/L작위림계치，PAPP-A예측난면유산적민감성、특이성화준학성분별위85．6％、82．3％화82．6％。이231．47 pg/mL작위림계치，억제소A예측난면유산적민감성、특이성화준학성분별위85．2％、83．5％화86．3％。이자연합검측시，예측난면유산적민감성、특이성화준학성분별위84．6％、86．6％화89．1％。결론 PA PP-A급억제소A대선조유산적결국구유일정적예측개치，이자연합검측가이제고진단특이성화준학성。
Objective To investigate the value of joint detection of pregnancy-associated plasma protein-A (PAPP-A) and inhib-in-A for the prediction of threatened abortion outcomes .Methods 462 pregnant women with 6-11 gestational weeks were selected and followed up to birth .Among them ,there were 43 pregnant women with inevitable abortion developed from threatened abortion (group A) ,52 continuous pregnant women after treatment of threatened abortion(group B) ,and 367 normal pregnant women(group C) .The levels of PAPP-A and inhibin-A in all the groups were detected by time-resolved fluoroimmuno assay and automatic en-zyme-linked immunoaorbent chemiluminescence assay ,respectively .Results The PAPP-A and inhibin-A concentrations of group A were significantly lower than group B and C (P<0 .05) .And the PAPP-A and inhibin-A concentrations of group B were lower than those of group C with no significant difference(P>0 .05) .With 98 .12 mU/L as the cut-off value ,the sensibility ,specificity and ve-racity of PAPP-A for the prognosis of inevitable abortion were 85 .6% ,82 .3% ,and 82 .6% ,respectively .With 231 .47 pg/mL as the cut-off value ,the sensibility ,specificity and veracity of inhibin-A for the prognosis of inevitable abortion were 85 .2% ,83 .5% , and 86 .3% ,respectively .The sensibility ,specificity and veracity of joint detection of PAPP-A and inhibin-A were 84 .6% ,86 .6% , and 89 .1% ,respectively .Conclusion PAPP-A and inhibin-A have a clinical value in the prognosis of threatened abortion ,and the joint detection can improve the specificity and accuracy .