血清抑制素A和激活素A浓度与稽留流产的关系研究

目的:了解抑制素A、激活素A在孕妇孕早期血清中的表达水平,探讨抑制素A、激活素A预测早期妊娠稽留流产的价值.方法:选择于我院行门诊产前检查的孕6～10周孕妇1000例为研究对象,采用ELISA法于孕6～8周或孕8～10周测定其血清抑制素A和激活素A的浓度水平,并追踪至孕13周,了解妊娠情况.对其中继续正常妊娠和发生稽留流产的孕妇的血清抑制素A、激活素A的浓度水平进行比较,并比较两者的临界值、敏感性和特异性.结果:无论在孕6～8周还是在孕8～10周,正常妊娠组血清抑制素A、激活素A水平均明显高于稽留流产组,差异有高度统计学意义(P＜0.01).检测血清抑制素A的临界值为＜230 ng/L,其预测孕早期稽留流产的敏感性为84.8％,特异性为77.4％；检测血清激活素A的临界值为＜162 ng/L,其预测孕早期稽留流产的敏感性为85.0％,特异性为88.7％.两者敏感性和特异性比较,差异无统计学意义(P＞0.05).结论:血清抑制素A、激活素A作为预测孕早期稽留流产的手段是可行的,且具有较高的敏感性和特异性,两者的诊断效能无优越性差别.

Relationship of Ihbibin A, Activin A and Retained Abortion

Objective: To determine the expresses of inhibin A and activin A in maternal serum of the normal early pregnancy and missed abortion,and the value of serum inhibin A in prediction of pregnancy outcome.Methods: 1000 cases of outpatient prenatal care of pregnancy 6 to 10 weeks were recruited in our hospital , serum inhibin A and activin A levels were measured by ELISA from 6 to 8 weeks and from 8 to 10 weeks respectively, and followed up until 13 weeks of gestation. Pregnancy situations, serum levels of inhibin A and activin A in normal and abortion groups , diagnostic thresould, sensitivity and specificity were compared. Results: Serum inhibin A, activin A in normal pregnancy were significantly higher than those of abortion group both in 6 to 8 gestation weeks or 8 to 10 gestation weeks,the difference was statistically significant (P<0.01). The thresould value of serum inhibin A in predicting the abortion was <230 ng/L, its sensitivity was 84.8%, specificity was 77.4%; The thresould value of serum activin A in predicting the abortion was <162 ng/L, its sensitivity was 85.0%, specificity was 88.7%. There was no difference in sensitivity and specificity for these two factors (P>0.05).Conclusions: It is feasible for serum inhibin A, activin A as a predictor of first trimester missed abortion for their high sensitivity and specificity, and there is no priority for either parameter to perform the diagnostic value.