以孕妇血清PAPP-A及其它妊娠蛋白为指标筛查异常胎儿

测定629例妊娠5～40周孕妇血清妊娠相关血浆蛋白A（PAPP－A）、甲胎蛋白（AFP）和人绒毛膜促性腺激素β亚基（β-hCG）。结果发现：无脑儿孕妇血清PAPP－A水平在妊娠早、中期均明显降低；在妊娠早、中期，胎儿21三体孕妇血清PAPP-A和AFP水平均下降，β-hCG水平升高。胚胎死亡和宫内死胎孕妇血清PAPP－A和β-hCG水平降低。提示此三种妊娠蛋白可在妊娠中期尤其是在妊娠早期作为筛查胎儿异常的重要指标，特别是对胎儿染色体异常和神经管缺陷（NTDs）的筛查。

USING MATERNAL SERUM PAPP-A AND OTHER PREGNANCY-ASSOCIATED PROTEINS IN SCREENING FOR FETAL ABNORMALITIES

Pregnancy-associated plasma protein A (PAPP-A), alphatetoprotein (AFP) and free betasubunit of human chorionic gonadotropin (β－hCG)levels in maternal sera of 629 samples were measured. The results showed that in women withaneucephaly the median valuerkr maternal serum PAPP-A were very low in both first and second trimester. In the same time, in women with fetal trisomv 21, the median values for maternal serum PAPP-A and AFP were very low, while maternal serum PhCG level was high. In women with fetal demise, the median values for maternal serum PAPP-A and β－hCG were very low, but very high for AFP. Our findings suggest that maternal serum PAPP-A, AFP and β－hCG are reliable markers not only in second trimester but also in first trimester in screening for fetal abnormalites, especially for fetal chromosomal abnormalities and neural tube defects.