易晓云

    [摘要] 目的 探討孕早期母亲血清妊娠相关血浆蛋白A(PAPP-A)、平均动脉压(MAP)、子宫动脉搏动指数(UtA-PI)联合筛查对预测子痫前期的应用价值。 方法 选取2018年10月至2020年6月自孕早期(孕11～13+6周)建档开始定期在我院产检的单胎妊娠孕妇，测定孕早期血清PAPP-A水平、MAP，采用彩色多普勒超声测定UtA-PI，随访妊娠结局，将发生子痫前期的10例孕妇作为观察组(其中早发型子痫前期组与晚发型子痫前期组各5例)，另选取同期未发生子痫前期的正常孕妇189名作为对照组。对三组孕妇的PAPP-A、MAP、UtA-PI中位数倍数(MoM值)行单因素分析，并分析PAPP-A、MAP、UtA-PI在预测子痫前期中的应用价值。 结果 观察组PAPP-A MoM值水平低于对照组，观察组MAP、MoM值水平均高于对照组，且差异均具有统计学意义(P<0.05);三组间UtA-PI水平比较，差异无统计学意义(P>0.05);PAPP-A、MAP为子痫前期独立预测因子(P<0.05);与PAPP-A、MAP、UtA-PI各指标单独检测相比较，联合检测在预测子痫前期的敏感度、特异度及ROC曲线下面积均最高。结论 孕早期PAPP-A、MAP、UtA-PI联合筛查在子痫前期预测中具有重要意义，可及时评估子痫前期发生风险，为临床诊断及干预提供依据。

    [关键词] 子痫前期;妊娠相关血浆蛋白A;平均动脉压;子宫动脉搏动指数

    [中图分类号] R714.244? ? ? ? ? [文献标识码] A? ? ? ? ? [文章编号] 1673-9701(2021)32-0022-04

    [Abstract] Objective To investigate the value of combined screening of pregnancy-associated plasma protein A (PAPP-A)， mean arterial pressure (MAP) and uterine artery pulsatility index in early pregnancy (UtA-PI) for predicting preeclampsia. Methods Pregnant women with singleton pregnancies who received regular prenatal examinations in our hospital from October 2018 to June 2020 (11～13+6 weeks of gestation) were selected. Serum PAPP-A level and MAP were measured in early pregnancy. UtA-PI was measured by color Doppler ultrasound. Pregnancy outcomes were followed up. Ten pregnant women with preeclampsia were selected as the observation group (including 5 cases of early-onset preeclampsia and 5 cases of late-onset preeclampsia) ......