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目的 探讨孕妇血浆纤维结合蛋白 (FN)水平变化对胎儿生长受限 (FGR)和妊娠高血压综合征 (妊高征 )的早期预测价值。方法 用免疫速率比浊法测定 130例孕妇血浆FN水平 ,并随访其妊娠结局。比较用FN水平预测FGR、妊高征、FGR合并妊高征 3种妊娠结局的预测价值。结果 (1)妊娠结局 :130例孕妇中发生FGR 10例 (FGR组 )、妊高征 10例 (妊高征组 )、FGR合并妊高征 4例 (FGR+妊高征组 )、无合并症的正常妊娠妇女 10 6例 (正常妊娠组 )。 4组孕妇间平均年龄、孕次、取样孕周、分娩孕周比较 ,差异无显著性 (P >0 0 5 )。 (2 )FGR组、妊高征组、FGR +妊高征组FN水平分别为(486 4 5± 12 2 6 9)mg/L、(42 8 38± 118 71)mg/L、(44 3 6 6± 6 8 13)mg/L ,均显著高于正常妊娠组(2 84 4 1± 93 83)mg/L(P <0 0 0 1)。 (3)FN水平预测FGR、妊高征、FGR +妊高征 3种妊娠结局的受试者工作曲线 (ROC曲线 )下面积 ,分别为 0 893、0 818、0 86 7。(4)以FN≥ 4 6 0mg/L为最佳切点预测 3种妊娠结局的敏感性、特异性、阳性预测值、阴性预测值及Kappa指数 ,FGR组为 :5 7 14 %、95 6 9%、6 1 5 4 %、94 87%、0 5 4 5 5 ;妊高征组为 :4 2 86 %、91 38%、37 5 0 %、92 98%、0 32 2 1;FGR +妊高征组为 :91 2 7%、5 0
Objective To investigate the early predictive value of changes in plasma fibronectin (FN) levels in fetus with impaired fetal growth (FGR) and pregnancy induced hypertension (PIH). Methods The plasma FN levels in 130 pregnant women were measured by the immunoturbidimetric method and their pregnancy outcomes were followed up. The predictive value of FN, Fetal Hypertension, FGR combined with PIH in pregnancy outcome was compared. Results (1) Pregnancy outcome: FGR group (10 cases), pregnancy induced hypertension syndrome group (10 cases), FGR combined with pregnancy induced hypertension (FGR + PIH group) Of 106 normal pregnant women (normal pregnancy group). There was no significant difference in average age, gestational age, sampling gestational age and gestational age between the four groups (P> 0.05). (2) The levels of FN in FGR group, PIH group and FGR + PIH group were (486 45 ± 12 269) mg / L, (42 8 38 ± 118 71) mg / L, 6 6 ± 6 8 13) mg / L, both of which were significantly higher than those of normal pregnancy group (8441 ± 93 83) mg / L (P 0 01). (3) The area under the receiver operating curve (ROC curve) of FN, FHI, FGR and PIH pregnancy outcomes were 0 893,0 818,0 86 7 respectively. (4) The sensitivity, specificity, positive predictive value, negative predictive value and Kappa index of three kinds of pregnancy outcomes were predicted by FN≥460mg / L. The FGR group was 57.14%, 956 9%, 6 1 5 4%, 94 87%, 0 5 4 5 5; PIH group were 4286%, 91 38%, 37 5 0%, 92 98%, 0 32 2 1; FGR + PIH group was 91 27%, 50