摘要
目的研究子痫前期孕妇外周血、脐血和胎盘组织妊娠相关血浆蛋白A(PAPP-A)水平及脐动脉S/D,探讨PAPP-A、脐动脉S/D与子痫前期的关系。方法 52例子痫前期孕妇,按发病孕周不同分为早发型组(≤32周)30例和晚发型组(>32周)22例,相匹配孕周正常孕妇各14例为对照组1、2;彩超测胎儿脐动脉S/D;ELISA法和免疫组化法分别测血清及胎盘PAPP-A水平。结果①早发型组及晚发型组外周血PAPP-A均高于对照组1、2(P<0.05),且早发型组高于晚发型组(P<0.05);早发型组及晚发型组脐血PAPP-A均高于对照组2(P<0.05);②早发型组胎盘PAPP-A高于对照组2和晚发型组(P<0.05);③早发型组及晚发型组胎儿脐动脉S/D均高于对照组1、2(P<0.05),且早发型组高于晚发型组(P<0.05);④早发型组外周血PAPP-A水平与脐动脉S/D呈正相关(P<0.05)。结论早发型子痫前期孕妇外周血PAPP-A和脐动脉S/D均升高,提示PAPP-A与早发型子痫前期的胎盘功能紊乱及子痫前期预后有关。
Objective To determine the maternal, umbilical cord serum alterations and placental pregnancy-associated plasma protein-A (PAPP-A) in preeclampsia (PE) and healthy pregnancies to assess if there is association between maternal and umbilical cord serum PAPP-A levels and umbilical artery systolic/diastolic (S/D) ratio in preeclampsia. Methods 52 pregnant women with PE were divided into early-onset group (n=30, onset time ≤ 32 gestational weeks) and late-onset group (n=22, onset time 〉 32 gestational weeks). 28 healthy pregnant women were included as control 1 (n=14, gestational age ≤ 32 weeks) and control 2 (n=14, gestational age 〉 32 weeks). Doppler velocimetry of umbilical artery systolic/diastolic (S/D) ratio was obtained in all fetuses. Enzyme-linked immunosorbent assay (ELISA) was used to detect the maternal and umbilical cord serum level of PAPP-A. Immunohistochemistry was used to detect placental PAPP-A expression. Results ① The maternal serum PAPP-A in early-onset and late-onset PE groups was significantly higher than that in control 1 and control 2 (P〈0.05), and it was higher in the early-onset PE group than that in the late-onset PE group (P〈0.05). The umbilical serum PAPP-A in early-onset and late-onset PE groups was significantly higher than that in control 2 (P〈0.05). ② The placental PAPP-A in early-onset PE group was significantly higher than that in late-onset PE group and control 2 (P〉0.05). ③ The umbilical artery S/D ratio in early-onset and late-onset PE groups was significantly higher than that in control 1 and control 2 (P〈0.05), and it′s higher in early-onset PE group than that in late-onset group (P〈0.05). ④ The maternal serum PAPP-A was positively correlated with umbilical artery S/D in early-onset PE group (P〈0.05). Conclusion Maternal serum PAPP-A level and umbilical artery S/D ratio are elevated in early-onset PE pregnancies. There is a positive correlation between maternal PAPP-A and umbilical artery S/D ratio in early-onset PE, indicating a possible connection with prognosis of early-onset preeclampsia.
出处
《山东大学学报(医学版)》
CAS
北大核心
2013年第11期78-81,共4页
Journal of Shandong University:Health Sciences
基金
山东省计生委资助项目(200715
200705)
关键词
妊娠相关血浆蛋白A
早发型子痫前期
脐动脉S
D
脐血
Pregnancy-associated plasma protein-A
Early-onset preeclampsia
Umbilical artery S/D
Umbilical blood