CAJ | 학술논문

目的：分析孕11+0~13+6周子痫前期高危人群中胎盘蛋白13（PP13）与胎盘生长因子（PLGF）在血清中的表达，评估其对高危人群子痫前期（pre-eclampsia，PE）的预测意义。方法随机选择孕龄为11+0~13+6周的子痫前期高危妊娠妇女208例，取外周血，采用ELISA法检测血清PP13、PLGF的浓度，追踪受检者的晚期妊娠情况及分娩情况，用ROC曲线分析PP13、PLGF单独和联合预测PE发生的灵敏度与特异性。结果208例孕妇中，发展为子痫前期者117例，包括92例轻度子痫前期和25例重度子痫前期（其中5例为早发型重度子痫前期）；除产科其他并发症的异常妊娠情况，正常妊娠结局56例作为对照组。孕11+0～13+6周的PE患者外周血与高危妊娠妇女中妊娠结局正常的孕妇比较，PP13分别为（41.80±10.09）pg/ml、（125.06±31.30）pg/ml，PLGF分别为（45.88±16.58）pg/ml、（97.06±25.40）pg/ml，差异有统计学意义（P<0.05）。 ROC曲线结果显示孕11+0~13+6周妊娠妇女的PP13、PLGF中位数倍数（MoM）之和预测PE的发生具有较高的灵敏度（96.7%）和特异性（96.3%）。结论在子痫前期的高危妊娠妇女中，PP13与PLGF联合检测对子痫前期的发生有较好的预测价值。
목적：분석잉11+0~13+6주자간전기고위인군중태반단백13（PP13）여태반생장인자（PLGF）재혈청중적표체，평고기대고위인군자간전기（pre-eclampsia，PE）적예측의의。방법수궤선택잉령위11+0~13+6주적자간전기고위임신부녀208례，취외주혈，채용ELISA법검측혈청PP13、PLGF적농도，추종수검자적만기임신정황급분면정황，용ROC곡선분석PP13、PLGF단독화연합예측PE발생적령민도여특이성。결과208례잉부중，발전위자간전기자117례，포괄92례경도자간전기화25례중도자간전기（기중5례위조발형중도자간전기）；제산과기타병발증적이상임신정황，정상임신결국56례작위대조조。잉11+0～13+6주적PE환자외주혈여고위임신부녀중임신결국정상적잉부비교，PP13분별위（41.80±10.09）pg/ml、（125.06±31.30）pg/ml，PLGF분별위（45.88±16.58）pg/ml、（97.06±25.40）pg/ml，차이유통계학의의（P<0.05）。 ROC곡선결과현시잉11+0~13+6주임신부녀적PP13、PLGF중위수배수（MoM）지화예측PE적발생구유교고적령민도（96.7%）화특이성（96.3%）。결론재자간전기적고위임신부녀중，PP13여PLGF연합검측대자간전기적발생유교호적예측개치。
Objective To analyse the level of placental protein-13 (PP13)and placental growth factor (PIGF) of serum during 11+0~13+6 weeks of gestation, to predict the risk of pre-eclampsia in pregnant women with high risk. Methods Select-ed 208 cases from women with pregnancy at 11+0~13+6 weeks of gestation.Samples were tested for PP13 and PLGF by enzyme-linked immunosorbent assay. The pathogenetic condition and pregnancy outcome of those cases were observed. The sensitivity and specificity of PP13 and PLGF for the prediction of PE were analyzed through receiver operating characteristic (ROC) curve. Results Among 208 previously normotensive women,117 developed into pre-eclampsia,including 25 severe and 92 mild pre-eclampsia. 56 abnormal cases remained normal till the end of pregnancy were selected as control group. During 11+0~13+6 weeks of gestation,serum level of PP13 and PIGF of gravida with PE was (41.80±10.09)pg/ml,(45.88±16.58)pg/ml,which was sig-nificantly different from (125.06±31.30)pg/ml and (97.06±25.40)pg/ml of healthy gravida (P<0.05),ROC curve indicated that the sum of multiple of the median (MoM) of serum PP13 and PIGF level during the first trimester had high sensitivity (96.7%) and specificity (96.3%) for predicting the risk of PE. Conclusion Combined the detection of PP13 with PLGF might has good clinical value for detecting PE in pregnant women with high risk.