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目的:评价孕15~20周孕妇血清中β-HCG与Pl GF水平变化与胎盘缺血性疾病(IPD)发病的关系及两者预测重度子痫前期(SPE)及低出生体重儿(LBWI)的价值。方法:选取2014年5月至2015年5月于北京大学深圳医院行产前检查并分娩的165例产妇,其中SPE 32例、LBWI 31例及正常妊娠孕妇102例。ELISA法检测β-HCG和Pl GF水平。应用Logistic回归及ROC曲线分析评价β-HCG和Pl GF单独或联合时预测SPE及LBWI的临床价值。结果:(1)与正常妊娠组比较,SPE组血清中β-HCG的Mo M值[中位数(p25,p75)]明显升高[0.96(0.71,1.17)Mo M vs 1.27(0.78,1.86)Mo M,P=0.012],LBWI组明显降低[0.73(0.53,1.07)Mo M,P=0.018]。SPE和LBWI组血清中Pl GF的Mo M值均较正常妊娠组明显下降[0.68(0.54,1.01)Mo M,0.89(0.66,1.53)Mo M vs 1.38(0.89,2.72)Mo M],差别有统计学意义(均P<0.01);(2)β-HCG与Pl GF单独或联合预测SPE的ROC曲线下面积(AUC)分别为0.664(95%CI为0.575~0.746,P=0.025)、0.818(95%CI为0.740~0.881,P<0.01)及0.906(95%CI为0.841~0.951,P<0.01)。β-HCG与Pl GF单独或联合预测LBWI的AUC分别为0.668(95%CI为0.580~0.748,P<0.01)、0.647(95%CI为0.558~0.728,P<0.05)和0.706(95%CI为0.620~0.783,P<0.01)。结论:中孕早期,β-HCG联合Pl GF对预测SPE和(或)LBWI发生有一定的临床价值和提示意义。
OBJECTIVE: To evaluate the relationship between serum levels of β-HCG and Pl GF and the incidence of placental ischemic disease (IPD) in pregnant women between the ages of 15 and 20 weeks and to predict the prevalence of severe preeclampsia (SPE) and low birth weight infants (LBWI) the value of. Methods: From May 2014 to May 2015, 165 maternal women were examined and delivered at Peking University Shenzhen Hospital, including 32 cases of SPE, 31 cases of LBWI and 102 cases of normal pregnant women. ELISA assay β-HCG and Pl GF levels. Logistic regression and ROC curve analysis were used to evaluate the clinical value of SPE and LBWI in predicting β-HCG and Pl GF alone or in combination. Results: (1) Compared with normal pregnancy group, the serum M M value of β-HCG in serum of the SPE group [median (p25, p75)] was significantly higher than that of the normal pregnancy group [0.96 (0.71,1.17) Mo M vs 1.27 ) Mo M, P = 0.012], the LBWI group significantly decreased [0.73 (0.53,1.07) Mo M, P = 0.018]. The values of Mo M in Pl GF in serum of SPE and LBWI group were significantly lower than those of normal pregnancy group [0.68 (0.54,1.01) Mo M, 0.89 (0.66,1.53) Mo M vs 1.38 (0.89,2.72) Mo M] (P <0.01). (2) The area under the ROC curve (AUC) predicted by β-HCG and PlGF alone or in combination was 0.664 (95% CI 0.575-0.746, P = 0.025) (95% CI: 0.740-0.881, P <0.01) and 0.906 (95% CI: 0.841-0.951, P <0.01). The AUC of β-HCG and PlGF alone or combined with LBWI were 0.668 (95% CI 0.580-0.748, P 0. 01), 0.647 (95% CI 0.558- 0.728, P 0. 05) and 0.706 95% CI 0.620 ~ 0.783, P <0.01). Conclusion: β-HCG combined with Pl-GF in early pregnancy may have certain clinical value and significance in predicting the occurrence of SPE and / or LBWI.