目的:了解中孕期孕妇血清甲胎蛋白(AFP)和游离人绒毛膜促性腺激素β亚基(free β-HCG)水平与子痫前期的相关性.方法:分析2015年1月至2016年8月在杭州市妇产科医院接受中孕期(妊娠15~20+6周)血清学产前筛查检测、妊娠晚期住院分娩的孕妇,根据子痫前期发病程度,将研究对象分为子痫前期组(n=55)和重度子痫前期组(n=36),同时期正常分娩孕妇中随机抽取100例作为对照组(n=100),检测孕妇血清标本AFP和free β-HCG水平,并比较其浓度分布情况.子痫前期和重度子痫前期与孕妇年龄、孕期、体质量、AFP和free β-HCG的关系采用非条件logistic回归分析.采用ROC曲线评价AFP和freeβ-HCG的筛查效能.结果:子痫前期组、重度子痫前期组AFP(MoM)水平均高于对照组,差异有统计学意义(P<0.01).经非条件logistic回归分析,孕妇血清AFP是子痫前期、重度子痫前期发病的主要危险因素(P<0.05),但其检测灵敏度偏低.结论:中孕期妇女血清高水平AFP(MoM)是妊娠子痫前期的危险因素,可预测晚期孕妇发生子痫前期可能,但其检测灵敏度偏低,单独筛查子痫前期价值有限,需要与其他标志物联合应用.%Objective: To determine if second-trimester maternal serum alpha-fetoprotein (AFP) level and free β-HCG level can predict preeclampsia. Methods: Second-trimester maternal serum levels of AFP and β-HCG in pregnancies who delivered in Hangzhou Women's Hospital from January 2015 to August 2016 were analyzed. A prospective case-control study included 55 mild preeclampsia patients, 36 severe preeclampsia pa-tients and 100 control pregnant women. AFP and free β-HCG among groups were compared. The correlation of age, weight, gestational age, AFP, free β-HCG and preeclampsia, severe preeclampsia were analyzed by uncon-ditional logistic regression analysis. The diagnostic efficacy of AFP and free β-HCG were evaluated by ROC curves. Results: AFP of mild preeclampsia group and severe preeclampsia group was significantly higher than control group (P<0.01). Logistic regression analysis showed that AFP was independent factor of mild and severe preeclampsia (P<0.05), but it has lower sensitivity. Conclusion: Higher second trimester maternal serum AFP level is a risk factor for preeclampsia. It can serve as a screening test for preeclampsia. However, single detection of AFP test is limited as the lower sensitivity. Combining other markers will make it more sufficient and reliable.
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