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孕早期和孕中期的PP13和妊娠相关血浆蛋白A:子痫前期的预测因素?

PP13 and PAPP-A in the First and Second Trimesters: Predictive Factors for Preeclampsia?

作者信息

Moslemi Zadeh Narges, Naghshvar Farshad, Peyvandi Sepideh, Gheshlaghi Parand, Ehetshami Sara

机构信息

OB/GYN Department, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.

出版信息

ISRN Obstet Gynecol. 2012;2012:263871. doi: 10.5402/2012/263871. Epub 2012 Jun 18.

Abstract

Background. Preeclampsia affects 5-6% of all pregnancies. Predictive factors of preeclampsia can be helpful in early diagnosis of this disease. In this study the predictive values of biochemical markers placenta protein 13 (PP13) and pregnancy-associated plasma protein A (PAPP-A) have been assessed in early diagnosis of preeclampsia. Methods. This case-control study was conducted on 1500 women who presented to a healthcare center of Sari, Iran, between 2010 and 2011. Blood samples were drawn in weeks 11-13 and 24-28 of pregnancy. Of them who developed preeclampsia were considered as case group. A control group consisted of similar women regarding mean age, body mass index (BMI), and pregnancy age. PAPP-A and PP13 serum levels were measured. Data were analyzed using proper statistical tests. Results. PAPP-A and PP13 serum levels were significantly lower in both the first and second trimesters in women who developed preeclampsia (P < 0.001). The cumulative value of all four variables with cut-off point of 238.5 has sensitivity, specificity of 91.0%, and undercurve surface of 0.968 which is the most diagnostic value for preeclampsia. Conclusion. It is possible to advantage measuring of PAPP-A and PP13 in the first and second trimesters especially their cumulative values in both trimesters for prediction of the incidence of preeclampsia.

摘要

背景。子痫前期影响所有妊娠的5 - 6%。子痫前期的预测因素有助于该疾病的早期诊断。在本研究中,评估了生化标志物胎盘蛋白13(PP13)和妊娠相关血浆蛋白A(PAPP - A)在子痫前期早期诊断中的预测价值。方法。本病例对照研究对2010年至2011年期间前往伊朗萨里一家医疗中心就诊的1500名女性进行。在妊娠第11 - 13周和24 - 28周采集血样。其中发生子痫前期的女性被视为病例组。对照组由年龄均值、体重指数(BMI)和妊娠年龄相似的女性组成。测量PAPP - A和PP13血清水平。使用适当的统计检验分析数据。结果。发生子痫前期的女性在孕早期和孕中期的PAPP - A和PP13血清水平均显著降低(P < 0.001)。四个变量的累积值在截断点为238.5时,灵敏度为91.0%,曲线下面积为0.968,这对子痫前期具有最高诊断价值。结论。在孕早期和孕中期测量PAPP - A和PP13,尤其是两者在两个孕期的累积值,有可能用于预测子痫前期的发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b201/3385696/138d54606a5e/ISRN.OBGYN2012-263871.001.jpg

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