孕妇, 孕周,血清碱性磷酸酶,正常参考值,队列研究 ," /> 孕妇, 孕周,血清碱性磷酸酶,正常参考值,队列研究 ,"/> Pregnant woman, Gestational week, Serum alkaline phosphatase, Normal reference value, Cohort study ,"/> <span style="font-size:14px;line-height:2;">孕妇不同孕周血清碱性磷酸酶变化规律的</span><span style="font-size:14px;line-height:2;">队列研究</span><span style="font-size:14px;line-height:2;"></span>
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发育医学电子杂志  2021, Vol. 9 Issue (1): 43-48    DOI: 10.3969/j.issn.2095-5340.2021.01.008
  围产医学   论著 |
孕妇不同孕周血清碱性磷酸酶变化规律的队列研究
伍丽婷 薛佳 李诗萌 袁正伟
中国医科大学附属盛京医院 卫生部小儿先天畸 形重点实验室,辽宁 沈阳 110004
An cohort study of change law of serum alkaline phosphatase in pregnant women with different gestation
Wu Liting, Xue Jia, Li Shimeng, et al
Key Laboratory of Congenital Malformation of Ministry of Health Shengjing Hospital Affiliated to China Medical University, Liaoning, Shenyang 110004, China
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摘要 【摘要】 目的  探讨孕妇血清碱性磷酸酶(alkaline phosphatase,ALP)水平在整个妊娠期的动态变化,为确定妊娠期不同孕周血清 ALP 的正常参考范围及其在不良妊娠结局中的变化情况提供相关依据。
法 采用前瞻性队列研究,招募 2017 年至 2018 年来盛京医院孕检的孕 7 周内 213 例孕妇为研究对象,
每隔 4 周进行清晨空腹静脉血采集检测血清 ALP,采用重复测量方差分析血清 ALP 变化特点,并追踪妊
娠结局。184 例孕妇完成随访,其中妊娠结局正常且资料完整者 122 例(正常组)及不良妊娠结局者 36 例
(不良妊娠组)纳入最终研究。分析孕妇不同孕周血清 ALP 的变化。 结果  两组间血清 ALP 比较差
异无统计学意义(P>0.05)。正常组孕妇孕早期 5 ~ 15 周血清 ALP 呈下降趋势,15 周后随孕周快速增加,产前达到峰值。孕 5 ~ 27 周血清 ALP 参考值范围低于正常参考值范围,其 cut off 值接近正常参考值
上限;而 37 ~ 39 周参考值范围明显升高,其 cut off 值为正常参考值上限 3 倍。 结论 健康孕妇在不
同孕期血清 ALP 浓度呈规律性变化,应根据不同孕期确立不同的正常参考值标准,且孕期定期检测其
变化情况对预测是否存在不良妊娠结局具有一定的指导意义。
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关键词:  孕妇')" href="#">    
Abstract: 
【Abstract】 Objective To explore the longitudinal changes of serum alkaline phosphates (ALP) in the
whole pregnancy of pregnant women , and provide relevant basis for determining the normal reference range of serum ALP in different gestational weeks and its changes in adverse pregnancy outcomes. Methods Based on prospective cohort study, 213 pregnant women within 7 weeks were recruited from 2017 to 2018 in Shengjing Hospital. The fasting venous blood were collected and the serum ALP were detected every 4 weeks, the change characteristics of ALP were analysed by replicate measures analysis of variance (ANOVA) , and the pregnancy outcome was tracked. 184 healthy pregnant women completed follow-up, and 122 pregnant women with normal pregnancy outcome and complete data(normal group), 36 pregnant women with adverse pregnancyoutcome(adverse pregnancy group), they were finally included in this study. The serum ALP change of the pregnant women with different gestational age was analysed. Results The serum ALP had no statistically significant difference between the two groups (P>0.05). In normal group, it showed a downward trend in the early pregnancy at 5-15 weeks, and increased rapidly with the gestational age after 15 weeks, reaching thepeak before delivery. The reference range of ALP in 5-27 weeks was lower than the normal reference interval,and its cut off value was close to the upper limit of the normal; while that in 37-39 weeks was significantly higher, its cut off value were 3 times of the upper limit of the normal reference. Conclusions Serum ALP level in whole pregnancy of normal pregnant women showed regular changes. Different normal reference value standards should be established according to different pregnancy periods, and regular detection of the changesduring pregnancy has certain guiding significance in predicting the existence of adverse pregnancy outcomes.
Key words:  Pregnant woman')" href="#">')" href="#"> Cohort study
收稿日期:  2020-04-08                     发布日期:  2021-01-28     
基金资助: 
:国家重点研发计划(2016YFC1000505);国家自然科学基金(81671469)
通讯作者:  袁正伟http://www.sj-hospital.org/show.php?mesid=3202    E-mail:  yuanzw@hotmail.com
引用本文:    
伍丽婷 薛佳 李诗萌 袁正伟. 孕妇不同孕周血清碱性磷酸酶变化规律的队列研究[J]. 发育医学电子杂志, 2021, 9(1): 43-48.
Wu Liting, Xue Jia, Li Shimeng, et al. An cohort study of change law of serum alkaline phosphatase in pregnant women with different gestation. Journal of Developmental Medicine(Electronic Version), 2021, 9(1): 43-48.
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