Randomized urinary and blood samples were obtained from three hundred and ninety-two cases of late pregnancies simultaneously for comparison of the validity in perinatal fetal monitoring. The results of randomized uri...Randomized urinary and blood samples were obtained from three hundred and ninety-two cases of late pregnancies simultaneously for comparison of the validity in perinatal fetal monitoring. The results of randomized urinary estriol/creatinine （RUE<sub>3</sub>/C） and serum free estriol （SFE<sub>3</sub>） tests revealed that Ⅰ. The coefficient of correlation between RUE<sub>3</sub>/C and SFE<sub>3</sub> level were close in either normal or high-risk pregnancies （y=0.1477X+14.2368, r=0.4586, n=170; y=0.1724X+8.6698, r=0.5868, n=222, respectively, P【0.001）; 2.92%cases of the false positive rate of RUE<sub>3</sub>/C were corrected by SFE<sub>3</sub> test. In cases of pregnancy-induced hypertension （PIH） the false positive rate of RUE<sub>3</sub>/C were highest in comparison with those in cuses of other high-risk pregnancies （53.6%）; 3. The correct rate of SFE<sub>3</sub> test in prenatal predication of fetal well-being was significantly higher （95.6%） than that of RUE<sub>3</sub>/C （87.3%） （X<sup>2</sup>=17.77, P【0.001）. This paper suggests that RUE<sub>3</sub>/C can be used as a first line test for perinatal monitoring. When RUE<sub>3</sub>/C value is lower than normal, SFE<sub>3</sub> test should be added to ensure the reliability of perinatal diagnosis, especially in PIH cases. Obviously, to use these two tests for perinatal fetal monitoring simultaneously is better than to use any one test alone.展开更多
A voltammetric sensor based on the electropolymerization of cobalt-poly(methionine)(Co-poly(Met)) on a glassy carbon electrode (GCE) was developed and applied for the determination of estriol by differential pulse vol...A voltammetric sensor based on the electropolymerization of cobalt-poly(methionine)(Co-poly(Met)) on a glassy carbon electrode (GCE) was developed and applied for the determination of estriol by differential pulse voltammetry (DPV) for the first time. The electrochemical properties of the Co-poly(Met)/GCE were analysed by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). Scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) were used to characterize the polymers on the GCE surface. The deposition of the Co-poly(Met) film on the GCE surface enhanced the sensor electronic transfer. CV studies revealed that estriol exhibits an irreversible oxidation peak at t0.58 V for the Co-poly(Met)/GCE (vs. Ag/AgCl reference electrode) in 0.10 mol/L Britton-Robinson buffer solution (pH=7.0). Different voltammetric scan rates (10-200 mV/s) suggested that the estriol oxidation on the Co-poly(Met)/GCE surface is controlled by adsorption and diffusion processes. Based on the optimized DPV conditions, the linear responses for estriol quantification were from 0.596 μmol/L to 4.76 μmol/L (R2 =0.996) and from 5.66 μmol/L to 9.90 μmol/L (R2 =0.994) with a limit of detection (LOD) of 0.0340 μmol/L and a limit of quantification (LOQ) of 0.113 μmol/L. The DPV-Co-poly(Met)/GCE method provided good intra-day and inter-day repeatability with RSD values lower than 5%. Also, no interference of real sample matrices was observed on the estriol voltammetric response, making the DPV-Copoly( Met)/GCE highly selective for estriol. The accuracy test showed that the estriol recovery was in the ranges 96.7%-103% and 98.7%-102% for pharmaceutical tablets and human urine, respectively. The estriol quantification in pharmaceutical tablets performed by the Co-poly(Met)/GCE-assisted DPV method was comparable to the official analytical protocols.展开更多
Background: Nowadays, a substantial number of women spend more than one-third of their lives in the postmenopausal period. It is characterized by a marked decrease in the production of estrogen, which leads to urogeni...Background: Nowadays, a substantial number of women spend more than one-third of their lives in the postmenopausal period. It is characterized by a marked decrease in the production of estrogen, which leads to urogenital atrophy. The symptoms stemming from vulvovaginal atrophy and the lower urinary tract are currently referred to as the Genitourinary Syndrome of Menopause (GSM), which can have a negative impact on the quality of life (QoL). Estrogen replacement is the ideal treatment for GSM, and vaginal administration is the most recommended. Objective: To assess the impact of the use of topical vaginal estriol on the quality of life (QoL) of postmenopausal women with lower urinary tract symptoms (LUTS). Methods: This is an interventional, prospective study, performed in 49 women at the Antonio Pedro Hospital, at the Universidade Federal Fluminense, in Niterói, Brazil, from August 2014 to April 2015. It included postmenopausal women with lower urinary tract symptoms who were not using any estrogen hormone therapy, and it excluded those with contraindications for the use of estriol. A specific questionnaire on QoL and urinary tract symptoms, the King’s Health Questionnaire (KHQ), which identifies LUTS and assesses to what extent those symptoms interfere with QoL, has been used as a research tool. Results: The average age was 62.24 years. Urinary urgency and urge incontinence were reported by 91.8% of women. The average scores of the domains of the KHQ decreased in the domains General Health Perception (before: 46.42 ± 21.65;after: 40.81 ± 22.64), Incontinence Impact (before: 74.82 ± 27.66;after: 41.49 ± 30.83), Role Limitations (before: 43.20 ± 32.80;after: 21.09 ± 24.71), Physical Limitations (before: 38.09 ± 32.09;after: 14.62 ± 24.20), Social Limitations (before: 30.38 ± 28.75;after: 12.62 ± 19.85), Emotions (before: 43.31 ± 32.96;after: 20.18 ± 26.41), Sleep/Energy (before: 41.48 ± 37.74;after: 15.98 ± 23.31) and Severity Measures (before: 48.02 ± 24.68;after: 22.31 ± 20.25). All the differences were statistically significant (p-value ≤ 0.05). Conclusion: In the group of postmenopausal women with lower urinary tract symptoms included in the study, the use of topical vaginal estriol led to a decrease in the frequency of each symptom and the average scores in all domains of the KHQ, suggesting a positive effect on women’s QoL.展开更多
A new unconjugated saliva estriol （SE<sub>3</sub>） determination by radioimmunoassay（<sup>3</sup>H-E<sub>3</sub>） was used to monitor 497 fetuses of late pregnancies, including ...A new unconjugated saliva estriol （SE<sub>3</sub>） determination by radioimmunoassay（<sup>3</sup>H-E<sub>3</sub>） was used to monitor 497 fetuses of late pregnancies, including 280 high-risk and217 normal pregnant women. The normal pregnant SE<sub>3</sub> values had been established by themeasurement of 1378 cases from 20 to 41 weeks of gestation. The results of SE<sub>3</sub> assaysrevealed that 1. In prenatal prediction of fetal well-being, the total false negative andfalse positive rates were 2.0% and 0.6%, respectively, the correct rate which was similarto that of serum free E<sub>3</sub> （SFE<sub>3</sub>） values was 97.4%, and was significantly higher thanthat of overnight 12-hour urine E<sub>3</sub>/C analyses as formerly reported. 2. There were 8 fetaldeathe in 11 cases with low SE<sub>3</sub> levels. No perinatal death occurred in the 486 cases withnormal SE<sub>3</sub> values, except one fetus who died of nuchal cord strangulation. It is highlyimportant that the saliva specimen be correctly collected and the technique ofmeasurement of SE<sub>3</sub> be carefully carried out. Our observations suggest that the clinicaluse of SE<sub>3</sub> assays are scientific, reliable, and it is more practicable than that of SFE3 as-says. The determination of SFE<sub>3</sub> can be replaced by SE<sub>3</sub> test for assessing fetal-placentalwell-being.展开更多
In this study the aqueous oxidation kinetics of estriol(E3)by potassium ferrate(K_(2)FeO_(4)),a chemical for its strong oxidizing power and for producing a coagulant from its reduced state(i.e.Fe(III)),was evaluated i...In this study the aqueous oxidation kinetics of estriol(E3)by potassium ferrate(K_(2)FeO_(4)),a chemical for its strong oxidizing power and for producing a coagulant from its reduced state(i.e.Fe(III)),was evaluated in the range of pH 8–12 with different molar ratios of the reactants.As the degree of Fe(VI)protonation varies with the solution pH,it was found that afirst order model was not suitable to describe the oxidation reaction.This paper describes a theoretical representation that closely models the reaction kinetics of E3 and ferrate.From this modeling,the reaction rates of HFeO_(4)^(-) and FeO_(4)^(2-) with E3 have been determined.The results show that the reactivity of HFeO–with dissociated and undissociated E3 is greater than that4 of FeO_(4)^(2-),and that E3 is more reactive in its dissociated state.展开更多
Objective:To develop an UPLC-MS/MS method for the accurate quantification of Estriol(E3),a new radioprotective agent,and observe the variation in pharmacokinetic characteristics of E3 after irradiation.As a hormone dr...Objective:To develop an UPLC-MS/MS method for the accurate quantification of Estriol(E3),a new radioprotective agent,and observe the variation in pharmacokinetic characteristics of E3 after irradiation.As a hormone drug,the gender differences of E3 metabolism were also concerned here.Methods:Various chromatographic and mass spectrometric conditions of E3 were optimized.The specificity,linearity,precision and accuracy of UPLC-MS/MS method were validated.Twenty SD rats,half male and half female,were administered with intramuscular(im)injection of 2.7 mg/kg E3,and then divided randomly into two groups,sham-irradiated group(Con)and irradiated group(IR).IR group was irradiated to 7 Gy ofγ-rays.Blood samples were collected at different times post-irradiation and E3 concentrations were detected.The changes of concentration-time variation and pharmacokinetic parameters for E3 after irradiation were investigated,together with metabolic differences between male and female rats.Results:The range of the calibration curve of UPLC-MS/MS for E3 was 1.00–200.0 ng/mL.Con group reached maximum concentration(Cmax)(77.57±18.71)ng/mL at(0.68±0.29)h(Tmax)after im injection.The drug concentration-time profiles and pharmacokinetic parameters of E3 were consistent before and after irradiation.The areas under time curve(AUC0-t)of E3 were(353±74)h⋅ng/mL for Con group,and(299±74)h⋅ng/mL for IR group(P>0.05).There were also no statistical differences in pharmacokinetic parameters between female and male rats.The elimination half-lifes(T1/2)of males and females were(3.02±0.68)h and(3.01±0.42)h in Con group,and(3.64±0.51)h and(3.38±0.60)h in IR group,respectively(P>0.05).Conclusion:A rapid and sensitive UPLC-MS/MS method for determination of E3 was established.The pharmacokinetic characteristics of E3 in rat were not affected by 7 Gy irradiation and gender differences.This study provided a theoretical basis for the development and application of new radiation injury treatment drug。展开更多
背景妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)可导致胎儿生长发育不良,早期预测至关重要,现有指标预警存在滞后性,本研究假设游离雌三醇(unconjugated estriol,UE3)、妊娠相关血清蛋白A(pregnancy-associated ...背景妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)可导致胎儿生长发育不良,早期预测至关重要,现有指标预警存在滞后性,本研究假设游离雌三醇(unconjugated estriol,UE3)、妊娠相关血清蛋白A(pregnancy-associated plasma protein-A,PAPP-A)及游离β绒毛膜促性腺激素(free beta-subunit of human chorionic gonadotropin,free-hcgβ)与胎儿生长发育相关,联合检测可提高预测效能.目的探讨外周血UE3、PAPP-A及free-hcgβ与ICP患者胎儿生长发育的相关性及其预测价值,以期为临床防治工作提供参考.方法选取2023-05/2025-04杭州市临平区妇幼保健院收治300例ICP患者,统计胎儿生长发育情况,并据此分为不良组(62例)、良好组(238例).比较两组患者的临床资料及外周血UE3、PAPP-A及free-hcgβ表达,Logistic回归分析ICP患者胎儿生长发育不良的影响因素,限制性立方样条(restricted cubic spline,RCS)曲线进一步探索UE3、PAPP-A、free-hcgβ与胎儿发育不良之间的剂量-反应关系,并采用受试者工作特征(receiver operating characteristic,ROC)曲线分析UE3、PAPP-A、free-hcgβ单独及联合检测对胎儿发育不良预测效能.结果300例ICP患者胎儿发育不良62例(20.67%);不良组重度/极重度ICP占比及总胆汁酸、谷草转氨酶、谷丙转氨酶、UE3、free-hcgβ表达高于良好组,PAPP-A表达低于好组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,校正ICP混杂因素后,UE3、PAPP-A及free-hcgβ仍是胎儿生长发育情况的影响因素(P<0.05);RCS分析结果显示,UE3、PAPP-A、free-hcgβ均与胎儿生长发育不良呈线性关系(Pnonlinear>0.05);ROC分析结果显示,UE3、PAPP-A、free-hcgβ联合预测胎儿生长发育不良的曲线下面积(area under curve,AUC)为0.923(95%CI:0.887-0.951),明显大于各指标单独预测价值的AUC(Z=3.018、3.583、3.355,均P<0.05).结论外周血UE3、PAPP-A及free-hcgβ均是ICP患者胎儿生长发育的影响因素,联合检测对胎儿生长发育不良具有一定预测价值,可作为临床预测胎儿生长发育情况的辅助指标,并可指导临床防治.展开更多
文摘Randomized urinary and blood samples were obtained from three hundred and ninety-two cases of late pregnancies simultaneously for comparison of the validity in perinatal fetal monitoring. The results of randomized urinary estriol/creatinine （RUE<sub>3</sub>/C） and serum free estriol （SFE<sub>3</sub>） tests revealed that Ⅰ. The coefficient of correlation between RUE<sub>3</sub>/C and SFE<sub>3</sub> level were close in either normal or high-risk pregnancies （y=0.1477X+14.2368, r=0.4586, n=170; y=0.1724X+8.6698, r=0.5868, n=222, respectively, P【0.001）; 2.92%cases of the false positive rate of RUE<sub>3</sub>/C were corrected by SFE<sub>3</sub> test. In cases of pregnancy-induced hypertension （PIH） the false positive rate of RUE<sub>3</sub>/C were highest in comparison with those in cuses of other high-risk pregnancies （53.6%）; 3. The correct rate of SFE<sub>3</sub> test in prenatal predication of fetal well-being was significantly higher （95.6%） than that of RUE<sub>3</sub>/C （87.3%） （X<sup>2</sup>=17.77, P【0.001）. This paper suggests that RUE<sub>3</sub>/C can be used as a first line test for perinatal monitoring. When RUE<sub>3</sub>/C value is lower than normal, SFE<sub>3</sub> test should be added to ensure the reliability of perinatal diagnosis, especially in PIH cases. Obviously, to use these two tests for perinatal fetal monitoring simultaneously is better than to use any one test alone.
基金CNPq (454438/2014-1)CAPES+1 种基金FINEPFAPEMIG for the financial support to this work
文摘A voltammetric sensor based on the electropolymerization of cobalt-poly(methionine)(Co-poly(Met)) on a glassy carbon electrode (GCE) was developed and applied for the determination of estriol by differential pulse voltammetry (DPV) for the first time. The electrochemical properties of the Co-poly(Met)/GCE were analysed by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). Scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) were used to characterize the polymers on the GCE surface. The deposition of the Co-poly(Met) film on the GCE surface enhanced the sensor electronic transfer. CV studies revealed that estriol exhibits an irreversible oxidation peak at t0.58 V for the Co-poly(Met)/GCE (vs. Ag/AgCl reference electrode) in 0.10 mol/L Britton-Robinson buffer solution (pH=7.0). Different voltammetric scan rates (10-200 mV/s) suggested that the estriol oxidation on the Co-poly(Met)/GCE surface is controlled by adsorption and diffusion processes. Based on the optimized DPV conditions, the linear responses for estriol quantification were from 0.596 μmol/L to 4.76 μmol/L (R2 =0.996) and from 5.66 μmol/L to 9.90 μmol/L (R2 =0.994) with a limit of detection (LOD) of 0.0340 μmol/L and a limit of quantification (LOQ) of 0.113 μmol/L. The DPV-Co-poly(Met)/GCE method provided good intra-day and inter-day repeatability with RSD values lower than 5%. Also, no interference of real sample matrices was observed on the estriol voltammetric response, making the DPV-Copoly( Met)/GCE highly selective for estriol. The accuracy test showed that the estriol recovery was in the ranges 96.7%-103% and 98.7%-102% for pharmaceutical tablets and human urine, respectively. The estriol quantification in pharmaceutical tablets performed by the Co-poly(Met)/GCE-assisted DPV method was comparable to the official analytical protocols.
文摘Background: Nowadays, a substantial number of women spend more than one-third of their lives in the postmenopausal period. It is characterized by a marked decrease in the production of estrogen, which leads to urogenital atrophy. The symptoms stemming from vulvovaginal atrophy and the lower urinary tract are currently referred to as the Genitourinary Syndrome of Menopause (GSM), which can have a negative impact on the quality of life (QoL). Estrogen replacement is the ideal treatment for GSM, and vaginal administration is the most recommended. Objective: To assess the impact of the use of topical vaginal estriol on the quality of life (QoL) of postmenopausal women with lower urinary tract symptoms (LUTS). Methods: This is an interventional, prospective study, performed in 49 women at the Antonio Pedro Hospital, at the Universidade Federal Fluminense, in Niterói, Brazil, from August 2014 to April 2015. It included postmenopausal women with lower urinary tract symptoms who were not using any estrogen hormone therapy, and it excluded those with contraindications for the use of estriol. A specific questionnaire on QoL and urinary tract symptoms, the King’s Health Questionnaire (KHQ), which identifies LUTS and assesses to what extent those symptoms interfere with QoL, has been used as a research tool. Results: The average age was 62.24 years. Urinary urgency and urge incontinence were reported by 91.8% of women. The average scores of the domains of the KHQ decreased in the domains General Health Perception (before: 46.42 ± 21.65;after: 40.81 ± 22.64), Incontinence Impact (before: 74.82 ± 27.66;after: 41.49 ± 30.83), Role Limitations (before: 43.20 ± 32.80;after: 21.09 ± 24.71), Physical Limitations (before: 38.09 ± 32.09;after: 14.62 ± 24.20), Social Limitations (before: 30.38 ± 28.75;after: 12.62 ± 19.85), Emotions (before: 43.31 ± 32.96;after: 20.18 ± 26.41), Sleep/Energy (before: 41.48 ± 37.74;after: 15.98 ± 23.31) and Severity Measures (before: 48.02 ± 24.68;after: 22.31 ± 20.25). All the differences were statistically significant (p-value ≤ 0.05). Conclusion: In the group of postmenopausal women with lower urinary tract symptoms included in the study, the use of topical vaginal estriol led to a decrease in the frequency of each symptom and the average scores in all domains of the KHQ, suggesting a positive effect on women’s QoL.
文摘A new unconjugated saliva estriol （SE<sub>3</sub>） determination by radioimmunoassay（<sup>3</sup>H-E<sub>3</sub>） was used to monitor 497 fetuses of late pregnancies, including 280 high-risk and217 normal pregnant women. The normal pregnant SE<sub>3</sub> values had been established by themeasurement of 1378 cases from 20 to 41 weeks of gestation. The results of SE<sub>3</sub> assaysrevealed that 1. In prenatal prediction of fetal well-being, the total false negative andfalse positive rates were 2.0% and 0.6%, respectively, the correct rate which was similarto that of serum free E<sub>3</sub> （SFE<sub>3</sub>） values was 97.4%, and was significantly higher thanthat of overnight 12-hour urine E<sub>3</sub>/C analyses as formerly reported. 2. There were 8 fetaldeathe in 11 cases with low SE<sub>3</sub> levels. No perinatal death occurred in the 486 cases withnormal SE<sub>3</sub> values, except one fetus who died of nuchal cord strangulation. It is highlyimportant that the saliva specimen be correctly collected and the technique ofmeasurement of SE<sub>3</sub> be carefully carried out. Our observations suggest that the clinicaluse of SE<sub>3</sub> assays are scientific, reliable, and it is more practicable than that of SFE3 as-says. The determination of SFE<sub>3</sub> can be replaced by SE<sub>3</sub> test for assessing fetal-placentalwell-being.
基金grateful for the financial support of National Key Technology R&D Program in the 11th Five year Plan of China(2006BAJ08B06)National Important Project(2008ZX07421-002)+2 种基金State Key Laboratory of Pollution Control and Resource Reuse Project(PCRRF08005)Shanghai Science and Technology Foundation“Innovation Plan of 2007”(No.072312001)the Research Committee of the Hong Kong Polytechnic University in providing a Ph.D scholarship for Cong Li and the China Postdoc Foundation.
文摘In this study the aqueous oxidation kinetics of estriol(E3)by potassium ferrate(K_(2)FeO_(4)),a chemical for its strong oxidizing power and for producing a coagulant from its reduced state(i.e.Fe(III)),was evaluated in the range of pH 8–12 with different molar ratios of the reactants.As the degree of Fe(VI)protonation varies with the solution pH,it was found that afirst order model was not suitable to describe the oxidation reaction.This paper describes a theoretical representation that closely models the reaction kinetics of E3 and ferrate.From this modeling,the reaction rates of HFeO_(4)^(-) and FeO_(4)^(2-) with E3 have been determined.The results show that the reactivity of HFeO–with dissociated and undissociated E3 is greater than that4 of FeO_(4)^(2-),and that E3 is more reactive in its dissociated state.
基金Beijing Municipal Natural Science Foundation(No.7202148).
文摘Objective:To develop an UPLC-MS/MS method for the accurate quantification of Estriol(E3),a new radioprotective agent,and observe the variation in pharmacokinetic characteristics of E3 after irradiation.As a hormone drug,the gender differences of E3 metabolism were also concerned here.Methods:Various chromatographic and mass spectrometric conditions of E3 were optimized.The specificity,linearity,precision and accuracy of UPLC-MS/MS method were validated.Twenty SD rats,half male and half female,were administered with intramuscular(im)injection of 2.7 mg/kg E3,and then divided randomly into two groups,sham-irradiated group(Con)and irradiated group(IR).IR group was irradiated to 7 Gy ofγ-rays.Blood samples were collected at different times post-irradiation and E3 concentrations were detected.The changes of concentration-time variation and pharmacokinetic parameters for E3 after irradiation were investigated,together with metabolic differences between male and female rats.Results:The range of the calibration curve of UPLC-MS/MS for E3 was 1.00–200.0 ng/mL.Con group reached maximum concentration(Cmax)(77.57±18.71)ng/mL at(0.68±0.29)h(Tmax)after im injection.The drug concentration-time profiles and pharmacokinetic parameters of E3 were consistent before and after irradiation.The areas under time curve(AUC0-t)of E3 were(353±74)h⋅ng/mL for Con group,and(299±74)h⋅ng/mL for IR group(P>0.05).There were also no statistical differences in pharmacokinetic parameters between female and male rats.The elimination half-lifes(T1/2)of males and females were(3.02±0.68)h and(3.01±0.42)h in Con group,and(3.64±0.51)h and(3.38±0.60)h in IR group,respectively(P>0.05).Conclusion:A rapid and sensitive UPLC-MS/MS method for determination of E3 was established.The pharmacokinetic characteristics of E3 in rat were not affected by 7 Gy irradiation and gender differences.This study provided a theoretical basis for the development and application of new radiation injury treatment drug。
文摘背景妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)可导致胎儿生长发育不良,早期预测至关重要,现有指标预警存在滞后性,本研究假设游离雌三醇(unconjugated estriol,UE3)、妊娠相关血清蛋白A(pregnancy-associated plasma protein-A,PAPP-A)及游离β绒毛膜促性腺激素(free beta-subunit of human chorionic gonadotropin,free-hcgβ)与胎儿生长发育相关,联合检测可提高预测效能.目的探讨外周血UE3、PAPP-A及free-hcgβ与ICP患者胎儿生长发育的相关性及其预测价值,以期为临床防治工作提供参考.方法选取2023-05/2025-04杭州市临平区妇幼保健院收治300例ICP患者,统计胎儿生长发育情况,并据此分为不良组(62例)、良好组(238例).比较两组患者的临床资料及外周血UE3、PAPP-A及free-hcgβ表达,Logistic回归分析ICP患者胎儿生长发育不良的影响因素,限制性立方样条(restricted cubic spline,RCS)曲线进一步探索UE3、PAPP-A、free-hcgβ与胎儿发育不良之间的剂量-反应关系,并采用受试者工作特征(receiver operating characteristic,ROC)曲线分析UE3、PAPP-A、free-hcgβ单独及联合检测对胎儿发育不良预测效能.结果300例ICP患者胎儿发育不良62例(20.67%);不良组重度/极重度ICP占比及总胆汁酸、谷草转氨酶、谷丙转氨酶、UE3、free-hcgβ表达高于良好组,PAPP-A表达低于好组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,校正ICP混杂因素后,UE3、PAPP-A及free-hcgβ仍是胎儿生长发育情况的影响因素(P<0.05);RCS分析结果显示,UE3、PAPP-A、free-hcgβ均与胎儿生长发育不良呈线性关系(Pnonlinear>0.05);ROC分析结果显示,UE3、PAPP-A、free-hcgβ联合预测胎儿生长发育不良的曲线下面积(area under curve,AUC)为0.923(95%CI:0.887-0.951),明显大于各指标单独预测价值的AUC(Z=3.018、3.583、3.355,均P<0.05).结论外周血UE3、PAPP-A及free-hcgβ均是ICP患者胎儿生长发育的影响因素,联合检测对胎儿生长发育不良具有一定预测价值,可作为临床预测胎儿生长发育情况的辅助指标,并可指导临床防治.
