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
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
目的探讨孕中期唐氏征筛查检查中AFP、Free-β-HCG、uE3中位数倍数(MOM)结果与胎儿染色体异常及其他先天畸形的关系。方法回顾性分析2009.1-2010.1在我院接受孕中期唐氏征筛查并成功随访的4250例单胎孕妇血清学筛查MOM(multiples of med...目的探讨孕中期唐氏征筛查检查中AFP、Free-β-HCG、uE3中位数倍数(MOM)结果与胎儿染色体异常及其他先天畸形的关系。方法回顾性分析2009.1-2010.1在我院接受孕中期唐氏征筛查并成功随访的4250例单胎孕妇血清学筛查MOM(multiples of median)值结果与胎儿染色体异常及其他畸形发生情况。结果在4250例孕妇中,共筛查出有MOM值异常404例,其中染色体异常7例,神经管缺陷及其他畸形14例。血清学MOM值正常孕妇中发现21-三体1例,其他胎儿畸形13例,两组比较,胎儿染色体异常及其他畸形发生率有显著差距。结论孕中期血清学筛查指标MOM值异常对胎儿染色体异常,神经管缺陷及其他先天异常的发现均有一定的预测价值。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.
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.
文摘目的探讨孕中期唐氏征筛查检查中AFP、Free-β-HCG、uE3中位数倍数(MOM)结果与胎儿染色体异常及其他先天畸形的关系。方法回顾性分析2009.1-2010.1在我院接受孕中期唐氏征筛查并成功随访的4250例单胎孕妇血清学筛查MOM(multiples of median)值结果与胎儿染色体异常及其他畸形发生情况。结果在4250例孕妇中,共筛查出有MOM值异常404例,其中染色体异常7例,神经管缺陷及其他畸形14例。血清学MOM值正常孕妇中发现21-三体1例,其他胎儿畸形13例,两组比较,胎儿染色体异常及其他畸形发生率有显著差距。结论孕中期血清学筛查指标MOM值异常对胎儿染色体异常,神经管缺陷及其他先天异常的发现均有一定的预测价值。
