| 黄杨,孟琳,吕慧,等.血清胎盘蛋白 -13及甲胎蛋白对子痫前期发生胎儿宫内生长受限的预测价值[J].安徽医药,2023,27(2):354-357. |
| 血清胎盘蛋白 -13及甲胎蛋白对子痫前期发生胎儿宫内生长受限的预测价值 |
| Predictive value of serum PP-13 and AFP for fetal intrauterine growth restriction in patients with preeclampsia |
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| DOI：10.3969/j.issn.1009-6469.2023.02.032 |
| 中文关键词: 胎儿生长迟缓 子痫前期 胎盘蛋白 -13 甲胎蛋白 |
| 英文关键词: Fetal growth retardation Preeclampsia Placental protein-13 Alpha fetoprotein |
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| 中文摘要: |
| 目的分析血清胎盘蛋白 -13(PP-13)、甲胎蛋白( AFP)预测子痫前期( PE)病人发生胎儿宫内生长受限( FGR)的价值。方法选择 2019年 1月至 2020年 12月徐州医科大学附属医院 120例 PE病人作为研究对象，测定病人孕 20周时血清 PP-13、 AFP，随访至分娩，根据病人 FGR发生情况分为 FGR组、非 FGR组，比较两组基线资料和孕 20周时血清 PP-13、AFP，经 logistic回归分析血清 PP-13、AFP与 PE病人发生 FGR的关系，绘制 ROC曲线分析孕 20周时血清 PP-13、AFP对 PE病人发生 FGR的预测价值。结果随访至病人分娩，统计 FGR发生情况显示，本研究内 120例 PE病人中有 23例发生 FGR，FGR发生率为 19.17%；FGR组病人 PE程度重于非 FGR组，舒张压( 101.87±10.31)mmHg、收缩压( 153.75±10.92)mmHg、AFP(2.18±0.37)MOM高于非 FGR组( 97.99±7.21)mmHg、(148.55±8.22)mmHg、(1.78±0.35)MOM，PP-13(0.94±0.15)μg/L低于非 FGR组( 1.17±0.24) μg/L，差异有统计学意义( P<0.05)；经 logistic回归分析结果显示，孕 20周血清 PP-13、AFP均与 PE病人发生 FGR有关， AFP可能是 PE病人发生 FGR的影响因素( OR>1，P<0.05)； PP-13可能是 PE病人发生 FGR的保护因素( OR<1，P<0.05)；绘制 ROC曲线图，结果显示，孕 20周时血清 PP-13、AFP预测 PE病人发生 FGR的 AUC分别为 0.79、0.78，均有一定预测价值；绘制决策曲线显示，联合孕 20周时血清 PP-13、AFP预测预测 PE病人发生 FGR的净受益率优于单独某一指标，最大值为 0.19。结论血清 PP-13、AFP与 PE病人发生 FGR有关，孕 20周血清 PP-13、AFP可用于预测 PE病人发生 FGR，且联合预测获得净受益率更高。 |
| 英文摘要: |
| Objective To analyze the value of serum placental protein-13 (PP-13) and alpha fetoprotein (AFP) in predicting fetal in-trauterine growth restriction (FGR) in patients with preeclampsia (PE).Methods A total of 120 patients with PE in the Affiliated Hos-pital of Xuzhou Medical University from January 2019 to December 2020 were selected as the research subjects, serum PP-13 and AFP of patients were measured at 20 weeks of pregnancy, followed up to delivery, patients were divided into FGR group and non-FGR group according to the occurrence of FGR of patients, the baseline data and serum PP-13 and AFP at 20 weeks of pregnancy were compared between the two groups, the relationship between serum PP-13, AFP and FGR in patients with PE was analyzed by Logistic regression,the ROC curve was drawn to analyze the predictive value of serum PP-13 and AFP on FGR in patients with PE at 20 weeks of pregnan-cy.Results The patients were followed up to delivery, the occurrence of FGR was counted and showed that, of 120 patients with PE inthis study, 23 developed FGR, the incidence of FGR was 19.17%; the degree of PE of patients in FGR group was heavier than that innon-FGR group, the diastolic blood pressure (101.87±10.31) mmHg, systolic blood pressure (153.75±10.92) mmHg, AFP (2.18±0.37)MOM were higher than those in non-FGR group (97.99±7.21) mmHg, (148.55±8.22) mmHg, (1.78±0.35) MOM, PP-13 (0.94±0.15) μg/L were lower than those in non-FGR group (1.17±0.24) μg/L, the differences were statistically significant (P<0.05); through Logistic re-gression analysis, the results showed that serum PP-13 and AFP at 20 weeks of pregnancy were related to FGR in patients with PE, AFPmight be the influencing factor of FGR in PE patients (OR>1,P<0.05); PP-13 might be a protective factor for FGR in PE patients (OR<1, P<0.05); the ROC curve was drawn, and the results showed that AUC of serum PP-13 and AFP at 20 weeks of gestation in predictingFGR in PE patients were 0.79 and 0.78, respectively, which had certain predictive value; the decision-making curve showed that the net benefit rate of serum PP-13 and AFP in predicting FGR in PE patients at 20 weeks of pregnancy was better than that of a single index,and the maximum value was 0.19.Conclusion Serum PP-13 and AFP are related to FGR in patients with PE, serum PP-13 and AFP at 20 weeks of gestation can be used to predict FGR in patients with PE, and the joint prediction obtains a higher net benefit rate. |
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