Leung T N, Chung T K, Madsen G, Lam C W, Lam P K, Walters W A, Smith R
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong.
Hum Reprod. 2000 Aug;15(8):1813-8. doi: 10.1093/humrep/15.8.1813.
The aims of this study were firstly to examine if corticotrophin-releasing hormone (CRH) concentrations in maternal plasma were significantly elevated in Chinese pregnancies complicated by pre-eclampsia, secondly to assess if this elevation could be detected in the mid-trimester before onset of clinical signs of the disease, and thirdly to evaluate the performance of using maternal CRH and/or alpha-fetoprotein (AFP) concentrations in the mid-trimester for prediction of pre-eclampsia. The first part of this study was tested in a cohort of 39 subjects. The CRH concentrations were significantly elevated in pregnant women complicated by pre-eclampsia. The second and third parts of the study involved a different cohort of 1021 subjects. Both CRH and AFP concentrations in the mid-trimester were significantly elevated in those who subsequently developed pre-eclampsia. However, when used for prediction of pre-eclampsia, neither the CRH nor AFP concentrations alone in the mid-trimester had strong predictive value. Although the combination of both tests improved the detection rate compared to the use of CRH alone, the small increase in the likelihood ratio from 1.9 to 2.6 did not suggest that the combination would be of great clinical value.
本研究的目的，一是检验在中国患有子痫前期的孕妇中，母体血浆中促肾上腺皮质激素释放激素（CRH）浓度是否显著升高；二是评估在疾病临床症状出现前的孕中期能否检测到这种升高；三是评估在孕中期使用母体CRH和/或甲胎蛋白（AFP）浓度预测子痫前期的效能。本研究的第一部分在39名受试者的队列中进行测试。患有子痫前期的孕妇中CRH浓度显著升高。研究的第二和第三部分涉及另一组1021名受试者。在随后发生子痫前期的受试者中，孕中期的CRH和AFP浓度均显著升高。然而，当用于预测子痫前期时，孕中期单独的CRH或AFP浓度均没有很强的预测价值。尽管与单独使用CRH相比，两种检测方法联合使用提高了检出率，但似然比仅从1.9小幅增加到2.6，这表明联合检测并没有很大的临床价值。
