Jauniaux Eric, Gulbis Béatrice, Jamil Amna, Jurkovic Davor
Department of Obstetrics and Gynaecology, University College Hospital (UCLH), 235 Euston Road, NW1 2BU, London, UK; Academic Department of Obstetrics and Gynaecology, UCL Institute for Women's Health, University College London (UCL), WC1E 6HX, London, UK.
Department of Clinical Chemistry, Erasme Hospital, Université Libre de Bruxelles (ULB), 808 Route de Lennik, 1070 Brussels, Belgium.
Reprod Biomed Online. 2015 Mar;30(3):268-74. doi: 10.1016/j.rbmo.2014.11.009. Epub 2014 Dec 5.
Maternal serum high-sensitivity C-reactive protein (HSCRP) was evaluated in predicting spontaneous abortion in spontaneous pregnancies presenting with threatened spontaneous abortion. Seventy-one cases of threatened spontaneous abortion (group A) and 71 asymptomatic controls (group B), matched for gestational and maternal age, body mass index and smoking status, were included. Maternal serum samples were evaluated for HCG, progesterone, pregnancy-associated plasma protein-A (PAPP-A) and HSCRP using standard bio-assays. No difference was observed in ultrasound measurements, and median progesterone maternal serum level was significantly lower (P < 0.05) in group A compared with group B. In group A, the median of all ultrasound and maternal serum parameters was significantly lower (P < 0.01) compared with group B. The median gestational sac diameter, volume and median HSCRP and PAPP-A levels were significantly increased (P < 0.05) in group A, with a normal outcome compared with group B, probably owing to the inflammatory reaction associated with intrauterine bleeding. In group A patients destined to abortion, the gestational sac development and corresponding protein synthesis fell before the fetal heart activity stopped; in spontaneous pregnancies, maternal serum HSCRP did not provide additional information for the management of threatened spontaneous abortion but warrants further research in assisted reproduction pregnancies.
对出现自然流产征兆的自然妊娠孕妇，评估其母血清高敏C反应蛋白（HSCRP）在预测自然流产中的作用。纳入71例自然流产征兆孕妇（A组）和71例无症状对照者（B组），两组在孕周、产妇年龄、体重指数和吸烟状况方面相匹配。采用标准生物测定法对母血清样本进行人绒毛膜促性腺激素（HCG）、孕酮、妊娠相关血浆蛋白A（PAPP-A）和HSCRP评估。超声测量结果无差异，A组母血清孕酮中位数显著低于B组（P<0.05）。与B组相比，A组所有超声和母血清参数的中位数显著更低（P<0.01）。与结局正常的B组相比，A组妊娠囊直径、体积以及HSCRP和PAPP-A水平中位数显著升高（P<0.05），这可能归因于与子宫内出血相关的炎症反应。在注定流产的A组患者中，妊娠囊发育和相应蛋白质合成在胎心活动停止前就已下降；在自然妊娠中，母血清HSCRP并未为自然流产征兆的处理提供更多信息，但在辅助生殖妊娠中值得进一步研究。
