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山东大学学报(医学版) ›› 2013, Vol. 51 ›› Issue (11): 78-81.

• 临床医学 • 上一篇    下一篇

PAPP-A、脐动脉S/D比值与子痫前期的相关性研究

刘颖1,展新风2,甄军晖3,马道新4,罗霞1   

  1. 山东大学齐鲁医院 1.妇产科; 2.超声科; 3.病理科; 4.血液科, 济南 250012
  • 收稿日期:2013-06-13 出版日期:2013-11-10 发布日期:2013-11-10
  • 通讯作者: 罗霞, E-mail:luoxia0311@163.com
  • 基金资助:

    山东省计生委资助项目(200715,200705)

Expression of PAPP-A in maternal serum, umbilical cord serum and placental tissue and umbilical artery S/D in preeclampsia

LIU Ying1, ZHAN Xin-feng2, ZHEN Jun-hui3, MA Dao-xin4, LUO Xia1   

  1. 1. Department of Obstetrics and Gynecology; 2. Department of Ultrasound;
    3. Department of Pathology; 4. Department of Hematology, Qilu Hospital of Shandong University, Jinan 250012, China
  • Received:2013-06-13 Online:2013-11-10 Published:2013-11-10

摘要:

目的  研究子痫前期孕妇外周血、脐血和胎盘组织妊娠相关血浆蛋白A(PAPP-A)水平及脐动脉S/D,探讨PAPP-A、脐动脉S/D与子痫前期的关系。方法  52例子痫前期孕妇,按发病孕周不同分为早发型组(≤32周)30例和晚发型组(>32周)22例,相匹配孕周正常孕妇各14例为对照组1、2;彩超测胎儿脐动脉S/D;ELISA法和免疫组化法分别测血清及胎盘PAPP-A水平。结果  ①早发型组及晚发型组外周血PAPP-A均高于对照组1、2(P<0.05),且早发型组高于晚发型组(P<0.05);早发型组及晚发型组脐血PAPP-A均高于对照组2(P<0.05);②早发型组胎盘PAPP-A高于对照组2和晚发型组(P<0.05);③早发型组及晚发型组胎儿脐动脉S/D均高于对照组1、2(P<0.05),且早发型组高于晚发型组(P<0.05);④早发型组外周血PAPP-A水平与脐动脉S/D呈正相关(P<0.05)。结论  早发型子痫前期孕妇外周血PAPP-A和脐动脉S/D均升高,提示PAPP-A与早发型子痫前期的胎盘功能紊乱及子痫前期预后有关。

关键词: 妊娠相关血浆蛋白A;早发型子痫前期;脐动脉S/D;脐血

Abstract:

Objective  To determine the maternal, umbilical cord serum alterations and placental pregnancy-associated plasma protein-A (PAPP-A) in preeclampsia (PE) and healthy pregnancies to assess if there is association between maternal and umbilical cord serum PAPP-A levels and umbilical artery systolic/diastolic (S/D) ratio in preeclampsia. Methods  52 pregnant women with PE were divided into early-onset group (n=30, onset time ≤ 32 gestational weeks) and late-onset group (n=22, onset time > 32 gestational weeks). 28 healthy pregnant women were included as control 1 (n=14, gestational age ≤ 32 weeks) and control 2 (n=14, gestational age > 32 weeks). Doppler velocimetry of umbilical artery systolic/diastolic (S/D) ratio was obtained in all fetuses. Enzyme-linked immunosorbent assay (ELISA) was used to detect the maternal and umbilical cord serum level of PAPP-A. Immunohistochemistry was used to detect placental PAPP-A expression. Results  ① The maternal serum PAPP-A in early-onset and late-onset PE groups was significantly higher than that in control 1 and control 2 (P<0.05), and it was higher in the early-onset PE group than that in the late-onset PE group (P<0.05). The umbilical serum PAPP-A in early-onset and late-onset PE groups was significantly higher than that in control 2 (P<0.05). ② The placental PAPP-A in early-onset PE group was significantly higher than that in late-onset PE group and control 2 (P>0.05). ③ The umbilical artery S/D ratio in early-onset and late-onset PE groups was significantly higher than that in control 1 and control 2 (P<0.05), and it′s higher in early-onset PE group than that in late-onset group (P<0.05). ④ The maternal serum PAPP-A was positively correlated with  umbilical artery S/D in early-onset PE group (P<0.05). Conclusion  Maternal serum PAPP-A level and umbilical artery S/D ratio are elevated in early-onset PE pregnancies. There is a positive correlation between maternal PAPP-A and umbilical artery S/D ratio in early-onset PE, indicating a possible connection with prognosis of early-onset preeclampsia.

Key words: Pregnancy-associated plasma protein-A; Early-onset preeclampsia; Umbilical artery S/D; Umbilical blood

中图分类号: 

  • R574
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