吴以刚广西容县妇幼保健院检验科，广西玉林　537500

妊娠相关血浆蛋白A检测标准化研究进展

吴以刚
广西容县妇幼保健院检验科，广西玉林537500

妊娠相关血浆蛋白A（PAPP-A）是临床常见的蛋白，该细胞由胎盘合体滋养细胞、蜕膜细胞等组成的大分子糖蛋白，由2个PAPP-A分子与2个嗜伊红主要碱性蛋白前体（proform of eosinphil major basic protein，proMBP）组成的异构聚合体，在胚子早期发育、孕卵的着床及妊娠的维持和胎儿的生长等方面均发挥了重要的作用。孕妇血清PAPPA浓度已成为检测非整倍体胎儿的可靠检测指标，同时PAPP-A测定在高危妊娠的筛选和监护及妊娠细胞疾病的诊断等方面均发挥了重要的作用。目前，PAPP-A检测标准化取得了一定进展，但还面临许多问题，不同实验间的检测结果差异明显，不具有可比性，给PAPP-A临床应用带来不便。因此，PAPP-A检测标准化是亟待解决的问题，目前亟需建立作为产前筛查标志物PAPP-A标准化参考测量系统和研制新的PAPP-A标准物质。

妊娠相关血浆蛋白A；PAPP-A；产前筛查；标准化

［Abstract］Pregnancy-associated plasma protein A is a common protein in clinic，and the cell is a macromolecular glycoprotein composed of urocortin in syncytiotrophoblast and decidua cells and an isomerism polymer composed of 2 PAPP-A molecules and 2 proform of eosinphil major basic proteins，which plays a major role in the early development of cotyledons，nidation，pregnancy maintenance and fetal growth，the serum PAPP-A concentration of pregnant women has become the reliable test indicator of aneuploid fetus，at the same time，the PAPP-A measure plays an importance role in the screening and monitoring of high-risk pregnancy and diagnosis of gestational cell disease，at present，the PAPP-A test standardization has got a certain process，but it is still faced with many issues，and the difference in the test result between different tests was obvious without comparability，which brings inconvenience to the clinical application of PAPP-A，therefore，PAPP-A test standardization is an urgent issue，at present，it is urgent to establish the prenatal screening mark PAPP-A standardized reference measurement system and develop the new PAPP-A reference material.

［Key words］Pregnancy-associated plasma protein A；PAPP-A；Prenatal screening；Standardization妊娠相关血浆蛋白（PAPP-A）最早于1974年国外学者在孕妇血液中测定，并发现PAPP-A浓度和胎盘功能有关。目前，在孕早期测定孕妇血清中PAPP-A已经应用于临床异常妊娠的预测，特别对于唐氏综合征（Down′s syndrome，DS）等染色体异常的筛选有较大的临床价值［1］。PAPP-A能够诊断孕期产妇及胎儿的健康状况［2］。PAPP-A与其他诊断方法相比优势较多，当机体内PAPP-A水平下降时，母血中PAPPA水平仍在升高，它是唯一一种在母血中最高，胎血不含的妊娠蛋白。同时，对于流产、早产、宫内死胎孕妇机体内PAPP-A含量也相对较低，该指标检测时灵敏度较高，特异性也比较强，在临床上研究也越来越多［4-5］。……