妊娠中期测定孕妇血清β-HCG、AFP及UE3水平对预测妊高征的意义.DOCVIP

临床医学论文-妊娠中期测定孕妇血清β-HCG、AFP及UE3水平对预测妊高征的意义 【摘要】? 目的 探讨测定中期妊娠孕妇血清β-HCG、AFP及UE3水平及测定MAP对预测妊高征的关系。方法 对2 363例中期妊娠孕妇抽取血标本测定血β-HCG、AFP及UE3值，同时测量MAP，并随访至分娩，观察上述指标与妊高征的关系。结果 有177例因各种原因除外后，余2 186例随访至分娩，发生妊高征179例，占8.2%。妊高征组血β-HCG、AFP值分别为（61.75±9.78）IU/L及（328.3±41.52）μg/L，显著高于正常孕妇组的（20.65±7.61）IU/L及（151.96±36.06）μg/L，P0.01。UE3为（53.7±20.11）ng/L，显著低于正常组的（81.45±34.36）ng/L，P0.05。当血β-HCG升高≥2 MOM，AFP值升高≥2.5 MOM时，预测妊高征发生率分别为39.8%（45/125）及29.8%（42/141），显著高于对照组的6.3%（134/2 090）及6.4%（137/2 045）。UE3下降≤0.5 MOM时预测妊高征发生率为29.8%（42/141），显著高于对照组的6.7%（137/2 045）。当MAP12 kPa时，预测妊高征发生率为26.4%（112/425）。在179例妊高征患者中有40例上述四种指标均明显高于预示值水平，且大多为重度子痫前期患者。结论 测定中期妊娠孕妇血清β-HCG、AFP及UE3及MAP对预示妊高征发生均有一定价值。当应用多指标联合监测可显著提高阳性预测率。 【关键词】? 中期妊娠；β-HCG；AFP；UE3；MAP；妊娠高血压综合征；预示 ??? ［Abstract］? Objective? To investigate the relationship between predicting PIH and determing serum β-HCG，AFP and UE3 levels in mid trimester of pregnancy as well as determing the MAP.Methods? In this study 2 363 gravidas in mid trimester of pregnancy were included，subjected to MAP measure and followed up to accouchement.Their serum specimens were collected to detect β-HCG，AFP and UE3 and we observed the relationship between the occurance of PIH and the above-mentioned targets.Results? Except 177 cases for various reasons，the remainder 2 186 cases were followed up to delivery，among which PIH occurred in 179 cases，accounting for 8.2%.In the PIH group，serum β-HCG and AFP values were（61.75±9.78）IU/L and（328.3±41.52）μg/L respectively，significantly higher than the normal group of pregnant women（20.65±7.61）IU/L and（151.96±36.06）μg/ L，P0.01.UE3 value was（53.7±20.11）ng/L，significantly lower than the normal group of（81.45±34.36）ng/L，P0.05.When the serum β-HCG rose≥2 MOM，AFP value increased≥2.5 MOM，prediction of the incidences of PIH was 39.8%（45/125）and 29.8%（42/141）that were significantly higher than the 6.3%（134/2 090）and 6.4%（137/2 045）of the control group.When UE3 dropped≤0.5 MOM，the prediction of PIH was 29.8%（42/141），significantly higher than 6.7%（137/