国际妇产科学杂志

国际妇产科学杂志 ›› 2016, Vol. 43 ›› Issue (1): 11-14.

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子痫前期预测指标的临床应用研究进展

徐亚玲，常颖，陈叙   

  1. 300070 天津医科大学（徐亚玲）；天津市中心妇产科医院（常颖，陈叙）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2016-02-15 发布日期:2016-02-15
  • 通讯作者: 陈叙

Progress of Pre-eclampsia Prediction Index in Clinical Application

XU Ya-ling，CHANG Ying，CHEN Xu   

  1. Tianjin Medical University，Tianjin 300070，China（XU Ya-ling）；Tianjin Central Hospital of Obstetrics and Gynecology，Tianjin 300100，China（CHANG Ying，CHEN Xu）
  • Received:1900-01-01 Revised:1900-01-01 Published:2016-02-15 Online:2016-02-15
  • Contact: CHEN Xu

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摘要： 子痫前期与孕产妇及其围生期发病率和病死率的增加关系密切。孕产妇子痫前期发病风险的早期识别可以有效地加强其孕期管理。预测子痫前期的监测方法包括临床病史、体格检查、实验室检查和血流动力学检查。一般来说，孕早期预测子痫前期发展的特异度好于敏感度，如：体质量指数（BMI）大于34 kg/m2、甲胎蛋白、纤连蛋白和子宫动脉多普勒（双侧）的特异度均超过90%。只有子宫动脉阻力指数和结合指数的敏感度超过60%。尿激肽释放酶等检查项目，在不考虑特异度的情况下具有高达80%以上的敏感度，但是其临床应用需要进一步的研究。目前，临床实践中子痫前期的预测多是几项检查指标的联合应用，没有一项检查项目具有足够的精确度可以独立使用。

关键词: 先兆子痫, 人体质量指数, 血压, 甲胎蛋白类, 纤连蛋白类, 超声检查, 多普勒, 敏感性与特异性

Abstract: Pre-eclampsia is closely associated with increased maternal and perinatal mortality and morbidity. Early recognition of women at risk of pre-eclampsia can effectively strengthen the management of the pregnancy. The tests used to predict pre-eclampsia include clinical history, examination findings, laboratory and haemodynamic tests. In general, tests in early pregnancy for predicting later development of pre-eclampsia have better specificity than sensitivity, as body mass index greater than 34 kg/m2, alpha-fetoprotein, fibronectin and uterine artery doppler (bilateral notching) all have specificities above 90%. Only uterine artery doppler resistance index and combinations of indices have a sensitivity of over 60%. Test such as kallikreinuria not used in clinical practice, has shown high sensitivity above 80%, without compromising specificity, and require further investigation. At present, the clinical practice of pre-eclampsia prediction is the joint application of several parameters, not a check project with sufficient accuracy can be used independently.

Key words: Pre-eclampsia, Body mass index, Blood pressure, alpha-fetoproteins, Fibronectins, Ultrasonography, Sensitivity and specificity