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妊娠 10 至 14 周时母体血清β-HCG 和 PAPP-A 水平在预测子痫前期中的作用。

The role of maternal serumbeta-HCG and PAPP-A levels at gestational weeks 10 to 14 in the prediction of pre-eclampsia.

机构信息

Ozkan Ozdamar, Department of Obstetrics and Gynecology, Golcuk Military Hospital, Golcuk, Kocaeli, Turkey.

Ismet Gun, Associate Professor, Department of Obstetrics and Gynecology,GATA Haydarpasa Training Hospital, Istanbul, Turkey.

出版信息

Pak J Med Sci. 2014 May;30(3):568-73. doi: 10.12669/pjms.303.4554.

Abstract

OBJECTIVE

We aimed to detect whether maternal serum free β-hCG and PAPP-A levels and NT measurements vary between normal pregnancies and those that subsequently develop pre-eclampsia and to evaluate the role of these screening serum analytes in the prediction of pre-eclampsia.

METHODS

Using a case-control study design, we identified all women who had been screened by double test within 11+0 and 13+6 weeks of gestation and who had developed pre-eclampsia during the subsequent pregnancy course, over a 6-year period between January 2006 and December 2012 at two tertiary referral hospital. All women who had undergone a double test during that time, without a diagnosis of pre-eclampsia and who had not had any adverse obstetric outcomes, were also identified, and three women among them were randomly selected as controls for each case. Maternal and neonatal data were abstracted from the medical records and PAPP-A, β-hCG, NT and CRL MoM values were compared between the two groups.

RESULTS

Although β-hCG values show no statistically significant difference (p=0.882), PAPP-A levels were significantly reduced in the pre-eclampsia group compared to the control group (p<0.001). NT and CRL values showed no significant difference between the two groups (p=0.674 and p=0.558, respectively).

CONCLUSION

Measuring PAPP-A in the first trimester may be useful in the prediction of pre-eclampsia.

摘要

目的

我们旨在检测母体血清游离β-hCG 和 PAPP-A 水平和 NT 测量值在正常妊娠和随后发展为子痫前期的妊娠之间是否存在差异,并评估这些筛查血清分析物在预测子痫前期中的作用。

方法

采用病例对照研究设计,我们在 2006 年 1 月至 2012 年 12 月的 6 年期间,在两家三级转诊医院,确定了所有在 11+0 至 13+6 周妊娠期间进行了双试验筛查且随后在妊娠过程中发展为子痫前期的女性,并确定了在同一时期进行了双试验筛查但未诊断为子痫前期且无不良产科结局的所有女性。从中随机选择 3 名女性作为每个病例的对照。从病历中提取母婴数据,并比较两组的 PAPP-A、β-hCG、NT 和 CRL MoM 值。

结果

虽然β-hCG 值没有统计学上的显著差异(p=0.882),但子痫前期组的 PAPP-A 水平明显低于对照组(p<0.001)。两组的 NT 和 CRL 值无显著差异(p=0.674 和 p=0.558)。

结论

在早孕期测量 PAPP-A 可能有助于预测子痫前期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b6/4048508/6826a347e98c/pjms-30-568-g001.jpg

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