血清PAPP-A、PP13和sFlt-1/PlGF比值检测对子痫前期高危孕妇PE发生的预测价值

Predictive value of serum PAPP-A, PP13 and sFlt-1/PlGF ratio for the occurrence of preeclampsia in high-risk pregnant women

摘要

目的 分析血清妊娠相关α血浆蛋白(PAPP-A)、胎盘蛋白13(PP13)和可溶性胎盘血管内皮生长因子受体-1(sFlt-1)/胎盘生长因子(PlGF)比值检测对子痫前期(PE)高危因素孕妇PE发生的预测价值。方法 选取2021年3月至2023年3月合肥市第二人民医院收治的187例具有PE高危因素的孕妇,根据妊娠20周后是否发生PE分为患病组(28例)和未患病组(159例).收集所有孕妇一般资料,并采用酶联免疫吸附试验检测所有孕妇血清PAPP-A、PP13、sFlt-1、PlGF水平,采用Pearson相关分析各指标的关系,绘制受试者工作特征(ROC)曲线评估各项指标对PE发生的预测价值。结果 妊娠16周及分娩前患病组血清PAPP-A水平均低于未患病组,血清PP13水平均高于未患病组,sFlt-1/PlGF比值均高于未患病组,差异有统计学意义(t值介于4.198~8.173之间,P<0.05);患病组孕妇经干预治疗后血清PAPP-A水平升高,血清PP13水平降低,sFlt-1/PlGF比值降低,差异有统计学意义(t值介于2.024~3.671之间,P<0.05);血清PAPP-A水平与PP13、sFlt-1/PlGF比值均呈负相关性(r值分别为-0.836、-0.775,P<0.05),血清PP13水平与sFlt-1/PlGF比值呈正相关性(r=0.670,P<0.05);ROC分析结果显示,血清PAPP-A、PP13、sFlt-1/PlGF预测PE发生的曲线下面积(AUC)分别为0.810、0.805、0.798,均有一定的预测价值(P<0.05)。结论 血清PAPP-A、PP13和sFlt-1/PlGF比值对PE高危因素孕妇发生PE有较高的预测价值.

Abstract

Objective To analyze the predictive value of serum pregnancy-associated plasma protein-A (PAPP-A), placental protein 13 (PP13) and the soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) ratio tests for the occurrence of preeclampsia (PE) in pregnant women with high-risk factors for PE. Methods A total of 187 pregnant women with high-risk factors for PE who were admitted to Hefei Second People's Hospital from March 2021 to March 2023 were selected. They were divided into a diseased group (28 cases) and a non-diseased group (159 cases) based on whether PE occurred after 20 weeks of gestation. General information was collected from all pregnant women, and serum levels of PAPP-A, PP13, sFlt-1 and PlGF were measured using enzyme-linked immunosorbent assay (ELISA). Pearson correlation analysis was used to examine the relationships among the indicators, and receiver operating characteristic (ROC) curves were plotted to assess the predictive value of each indicator for the occurrence of PE. Results The serum PAPP-A levels in the diseased group were lower than those in the non-diseased group at 16 weeks of gestation and before delivery, while serum PP13 levels and the sFlt-1/PlGF ratio were higher in the diseased group, with statistically significant differences (t=4.198-8.173, P<0.05). After intervention treatment, the diseased group showed increased serum PAPP-A levels, decreased serum PP13 levels, and a reduced sFlt-1/PlGF ratio, with statistically significant differences (t=2.024-3.671, P<0.05). The levels of serum PAPP-A were negatively correlated with PP13 and sFlt-1/PlGF ratio (r=-0.836 and -0.775, respectively, P<0.05), and serum PP13 levels were positively correlated with sFlt-1/PlGF ratio (r=0.670, P<0.05). ROC analysis results showed that area under the curve (AUC) for predicting PE occurrence was 0.810 for serum PAPP-A, 0.805 for PP13, and 0.798 for the sFlt-1/PlGF ratio, all of which had certain predictive value (P<0.05). Conclusion Serum PAPP-A, PP13 and sFlt-1/PlGF ratio have high predictive value for the occurrence of PE in pregnant women with high-risk factors.

关键词

子痫前期 / 妊娠相关α血浆蛋白 / 胎盘蛋白13 / 可溶性胎盘血管内皮生长因子受体-1 / 胎盘生长因子

Key words

preeclampsia / pregnancy-associated plasma protein-A / placental protein 13 / soluble fms-like tyrosine kinase-1 / placental growth factor

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