CAJ | 학술논문

目的：测定正常足月孕妇、妊娠期高血压、妊娠合并糖尿病及胎死宫内孕妇的孕期血清中缩宫素酶( P-LAP)水平,并研究其与妊娠结局的相关性。方法选取117例孕期规范产检并在本院分娩或引产的孕妇作为研究对象,包括妊娠期高血压38例、妊娠合并糖尿病35例、胎死宫内14例及正常足月孕妇30例。通过酶联免疫吸附试验( ELISA法)测定并比较各分组孕妇孕期血清中缩宫素酶( P-LAP)水平,并根据其浓度值绘制ROC曲线。结果各组血清P-LAP水平比较,正常孕妇组明显高于其余各组,胎死宫内组最低,组间比较差异有显著性(P<0.05)。妊娠合并高血压组与妊娠合并糖尿病组之间比较差异无显著性(P>0.05)。各组血清ROC曲线下面积为0.75,当血清P-LAP取47.07 U/L时,预测胎死宫内敏感性为75.0%,特异性为44.7%,血清 P-LAP取12.82 U/L时,预测胎死宫内敏感性为98.6%,特异性为68.4%,而当血清P-LAP取0.11 U/L时,预测胎死宫内敏感性为100%,特异性为100%。结论妊娠期高血压、妊娠合并糖尿病孕妇孕期血清P-LAP水平较低,孕晚期,当P-LAP值低于12.82 U/L时,可能提示胎儿预后不良,存在较大的死胎风险,应及时采取措施干预。
목적：측정정상족월잉부、임신기고혈압、임신합병당뇨병급태사궁내잉부적잉기혈청중축궁소매( P-LAP)수평,병연구기여임신결국적상관성。방법선취117례잉기규범산검병재본원분면혹인산적잉부작위연구대상,포괄임신기고혈압38례、임신합병당뇨병35례、태사궁내14례급정상족월잉부30례。통과매련면역흡부시험( ELISA법)측정병비교각분조잉부잉기혈청중축궁소매( P-LAP)수평,병근거기농도치회제ROC곡선。결과각조혈청P-LAP수평비교,정상잉부조명현고우기여각조,태사궁내조최저,조간비교차이유현저성(P<0.05)。임신합병고혈압조여임신합병당뇨병조지간비교차이무현저성(P>0.05)。각조혈청ROC곡선하면적위0.75,당혈청P-LAP취47.07 U/L시,예측태사궁내민감성위75.0%,특이성위44.7%,혈청 P-LAP취12.82 U/L시,예측태사궁내민감성위98.6%,특이성위68.4%,이당혈청P-LAP취0.11 U/L시,예측태사궁내민감성위100%,특이성위100%。결론임신기고혈압、임신합병당뇨병잉부잉기혈청P-LAP수평교저,잉만기,당P-LAP치저우12.82 U/L시,가능제시태인예후불량,존재교대적사태풍험,응급시채취조시간예。
Objective To Analyze the changes of serum P-LAP levels which from normal term pregnant women、hy-pertensive disorder complicating pregnancy and pregnancy associated with diabetes women, research the correlation of its changes and the outcome of pregnancy. Methods 117 cases were selected who delivery in our hospital as the objects of our study,All of them were took the prenatal examination regularly. These objects including 38 cases of hypertensive disor-der complicating pregnancy,35 cases of pregnant women with diabetes mellitus and 14 cases of fetal death,30 cases of nor-mal pregnant women. The levels of these women's serum P-LAP was measured by the ELISA,and draw the ROC curve ac-cording to the serum P-LAP concentrations. Results Compare the serum of each group's P-LAP levels. The normal group is the highest,and the fetal death group have the lowest level (P<0. 05). There are not difference between hypertensive disorder complicating pregnancy group and pregnancy associated with diabetes group (P>0. 05). The area under curve (AUC) of serum P-LAP concentration ROC curve in every group is 0. 75. According to the ROC curve,when the serum P-LAP concentration is 47. 07 U/L,the sensitivity to predict fetal death is 75. 0%,and the specificity is 44. 7%. when its con-centration is 12. 82 U/L,the sensitivity is 98. 6%,the specificity is 68. 4%,and when the concentration is 0. 11 U/L,the sensitivity and specificity are 100%. Conclusion The P-LAP level in hypertension disorders complicating pregnancy and pregnancy associated with diabetes group is lower. When the level of P-LAP was less than 12. 82 U/L in late pregnancy that may indicated that the fetal will have bad prognosis,it may have great risk of fetal death,and some measure should be taken.