Objective To study the predictive value of early diastolic notch of uterine artery combined with pregnancy associated plasma protein-A(PAPP-A)in preeclampsia.Methods Eighty-six preeclampsia pregnant women admitted to Handan First Hospital from June 2020 to June 2023 were selected retrospectively as the observation group,and 86 healthy pregnant women admitted at the same time were selected as the control group.PAPP-A level and early diastolic notch index of right and left uterine arteries were measured in both groups at 11-13+6 weeks of pregnancy.The right notch index,left notch index and PAPP-A level of pregnant women in the two groups were compared.Meanwhile,the area under receiver operating characteristic curve(AUC)of right notch index,left notch index,PAPP-A alone and jointly diagnosed preeclampsia was calculated and compared,and AUC between right notch index combined with PAPP-A and left notch index combined with PAPP-A was cal-culated and compared.Results The right and left notch index and PAPP-A level of pregnant women in the study group were 0.71±0.21,0.65±0.27,(3 504.84±1 598.38)mU/L,which were significantly lower than those in the control group[0.84±0.18,0.82±0.29,(5 019.47±2 498.96)mU/L],the differences were statistically significant(P＜0.05).The critical value of right notch index in preeclampsia prediction was 0.79,the sensitivity was 64.38％,the specificity was 60.08％,AUC was 0.658,95％CI was 0.585-0.731.The critical value of left notch index in preeclampsia prediction was 0.71,sensitivity was 61.57％,specificity was 71.76％,AUC was 0.684,and 95％CI was 0.612-0.757.The critical value of PAPP-A in preeclampsia prediction was 4 003.5 mU/L,the sensitivity was 68.47％,the specificity was 56.89％,AUC was 0.673,and 95％CI was 0.604-0.742.The sensitivity of joint prediction in preeclampsia prediction was 71.18％,the specificity was 75.47％,AUC was 0.772,and 95％CI was 0.711-0.834.The joint prediction of right and left notch index and PAPP-A for AUC of pre-eclampsia was greater than that of single index,and the difference was statistically significant(P＜0.05).The sensitivity of right notch index combined with PAPP-A in preeclampsia prediction was 54.76％,specificity was 80.27％,AUC was 0.739,and 95％CI was 0.674-0.804.The sensitivity of left notch index combined with PAPP-A was 80.79％,specificity was 62.79％,AUC was 0.757,and 95％CI was 0.695-0.818.The AUC of left notch index combined with PAPP-A in predicting preeclampsia was greater than that of right notch index combined with PAPP-A,and the difference was statistically significant(P＜0.05).Conclusion Single uterine artery early diastolic right and left notch indi-ces or PAPP-A have good predictive effects in predicting preeclampsia,while the combined detection of right and left notch indices and PAPP-A in early uterine artery diastolic has higher predictive value.At the same time,the combination of left notch indices and PAPP-A predicts the value of preeclampsia higher than that of right notch indices combined with PAPP-A.
关键词
子痫前期/妊娠相关血浆蛋白A/子宫动脉舒张早期切迹/预测价值
Key words
Pre-eclampsia/Pregnancy associated plasma protein A/Early diastolic notch of uterine artery/Predicted value
维普
万方数据