| Objectivethrough this study,we detected the levels of maternal serum PP13 and color doppler flow imaging of uterine artery pulsation index(PI)and investigated the relationship between PP13 and uterine artery PI,single index and joint detection of preeclampsia,especially in early-onset preeclampsia diagnostic value,in order to provide reliable theoretical basis for intervention and treatment.MethodsWe selected the fellowship in October 2015 to October 2017 at Jilin University Hospital with preeclampsia pregnant women 50 cases,20 cases of early-onset preeclampsia group(gestational age < 34 weeks),late-onset preeclampsia group 30 cases(gestational age 34 weeks or higher)disease.The diagnosis of preeclampsia standards with reference to the gestational hypertension disease diagnosis and treatment guidelines(2015).In addition,50 normal pregnant women with no pregnancy complications and complications were selected as normal control group.None of the subjects had chronic hypertension,diabetes,heart disease or kidney disease.The average age of the three groups of pregnant women and the number of pregnancies were compared.By adopting the method of time-resolved fluorescence immunoassay(TRFIA)were determined preeclampsia group(including early-onset preeclampsia group and late-onset preeclampsia group)and normal control group,the levels of serum PP13,line and color doppler flow imaging of uterine artery pulsation index(PI)value,using excel and statistical software for statistical data from SPSS19.0,sorting,nuclear inspection and analysis.ResultThere was no statistically significant difference about age 、pregnancy times and delivery times between the normal control group,the early-onset preeclampsia group and the late-onset preeclampsia group in the three groups(P>0.05).The systolic blood pressure and diastolic blood pressure were higher in the early-onset preeclampsia group than in the late-onset preeclampsia group,and the difference was statistically significant(P < 0.05).In the preeclampsia pregnancy complications,liver and kidney function damage.Hypoalbuminemia,placental abruption and HELLP syndrome are more common,and the perinatal outcome is less than fetal age,fetal distress,neonatal asphyxia and perinatal death.The complications of preeclampsia group and perinatal outcomes were higher than those of late onset preeclampsia group,and the difference was statistically significant(P < 0.05).In the normal control group,early preeclampsia group and late onset preeclampsia group,the PP13 level in peripheral venous serum of the three groups was(107.3±25.3)pg/mL,(164.4±23.6)pg/m L,(145.1±or 25.3)pg/mL.The value of the uterine artery pulsation index(PI)was(0.74±0.29),(1.16±0.32),and(0.99±0.27).The overall difference between the three groups was statistically significant(P< 0.05).Compared further between groups: normal control group and early-onset preeclampsia group and normal control group and late-onset preeclampsia group,the early-onset preeclampsia group and late-onset preeclampsia group of pregnant women in the peripheral venous blood level of PP13,uterine artery pulsation index(PI)difference had statistical significance(P< 0.05).The highest level of PP13 and the maximum of the uterine artery pulsation index(PI)in pregnant women were early preeclampsia group,the late onset preeclampsia group were lower and the normal control group were lowest.The serum PP13 level of pregnant women in normal control group had no correlation with the uterine artery PI value(P> 0.05).There was a positive correlation between the serum PP13 level and the uterine artery PI value in the preeclampsia group(P< 0.05).Correlation coefficient r=0.430.The higher the level of PP13,the greater the PI value of the uterine artery.The PP13 and uterine arterial pulse index were used as a single test index and a combined index and the area under the ROC curve of preeclampsia detection was 0.882,0.769 and 0.906 respectively.The truncated value of PP13 was 129.3pg/m L,with the largest Youden index,with the sensitivity and specificity of 78% and 76% respectively.The truncation value of the uterine artery pulsation index was 0.93,the maximum Youden index,sensitivity and specificity were 66% and 70%.As a test indicator,the diagnostic sensitivity and specificity of preeclampsia were 82% and 80%,and the combination of the two was higher than that of single test,and the diagnosis value of preeclampsia was higher.ConclusionEarly onset preeclampsia compared with late onset preeclampsia,the onset time was earlier,more serious,and more prone to multiple complications.In the perinatal outcome,early onset preeclampsia is more likely to occur with fetal growth restriction,fetal distress,neonatal asphyxia,fetal death,etc.The maternal peripheral blood PP13 level and the uterine arterial pulsation index(PI)were significantly higher than those in the normal period.Early-onset preeclampsia is higher than late onset preeclampsia.They are positively correlated.This suggests that PP13 may be related to the change of the placental circulation resistance,and involved in the onset of preeclampsia by affecting the recast of the uterine spiral artery.Whether it was the blood serum index PP13 or the physical index of the uterine arterial pulsation index(PI),the value of the two separately diagnosed preeclampsia was general.However,the sensitivity and specificity of the combined diagnosis were higher than that of single test,which could be used as a good indicator for the diagnosis of preeclampsia.It also suggests that different research methods can be combined to provide better solutions for disease prediction,diagnosis and treatment. |
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