【摘要】 目的：探索血清胱抑素C(CysC)、子宫动脉搏动指数(UtAPI)与子痫前期(PE)的关系，评价血清CysC联合UtAPI对子痫前期发病的预测能力。方法：采用前瞻性病例对照的方法对24例子痫前期孕妇和190例健康孕妇不同孕周的血清CysC和双侧UtAPI指标进行比较，结合Logistic回归分析影响子痫前期发病的独立危险因素，并采用受试者工作曲线(ROC)分析血清CysC联合双侧UtAPI对子痫前期发病的预测能力。结果：子痫前期组孕12～16周、22～26周、28～30周、32～34周和36～38周孕妇血清CysC均显著高于正常妊娠组(P<0.05)。正常妊娠组随着孕周的增加双侧UtAPI值进行性减少，差异具有统计学意义(P<0.001),而孕周与血清CysC水平无关(P>0.05)。Logistic回归分析显示，孕12～16周的孕妇血清CysC和双侧UtAPI值以及孕36～38周血清CysC是子痫前期发病的独立危险因子。ROC曲线分析，12～16周血清CysC联合双侧UtAPI可以有效预测子痫前期的发生，曲线下面积为0.805。结论：早孕期血清CysC联合双侧UtAPI可能是预测子痫前期发病的重要标记物。更多还原

【Abstract】 Objective:To explore the correlation between serum cystatin C, uterine artery pulsation index with pre-eclampsia and to assess the predictive efficiency of serum cystatin C levels united uterine artery pulsatility index in pregnant women with pre-eclampsia in the trimester of pregnancy.Methods:A prospective case-control study was conducted to compare the serum cystatin C and bilateral uterine artery pulsation index in 24 pregnant women with pre-eclampsia and 190 healthy pregnant women at different gestational weeks.The independent risk factors of pre-eclampsia were analyzed by multivariate logistic regression.The receiver operater characteristic curve was used to analyze the predictive ability of serum cystatin C combined with bilateral uterine artery pulsation index for pre-eclampsia in pregnant women with pre-eclampsia.Results:Serum CysC levels were significantly higher in the pre-eclampsia group than in control group at 12～16,22～26, 28～30, 32～34 and 36～38 weeks of pregnancy(P<0.05). The bilateral UtAPI value significantly decreased as the week of gestation increased in the control group(P<0.001), while there was no relation with the gestational week with the serum CysC level(P>0.05).Logistic regression analysis showed that serum CysC levels and bilateral UTAPI at 12～16 weeks of pregnancy and serum CysC levels at 36～38 weeks were independent risk factors for pre-eclampsia.The analysis of ROC demonstrated that serum CysC united bilateral UtAPI at 12～16 weeks had an effective diagnostic accuracy for pre-eclampsia(AUC=0.805).Conclusion:Serum CysC united bilateral UtAPI had high diagnostic accuracy and; thus, may serve as the candidate for pre-eclampsia screening in the trimester of pregnancy.更多还原