정상 임산부의 혈청 Alpha-fetoprotein치의 임상적 이용

Values of Alpha-fetoprotein of Maternal Serum in Normal Pregnancy

1993년 1월부터 1996년 9월까지 영남대학교 의과대학 부속병원 산부인과에 내원한 임신 8주에서 41주까지의 정상임산부 500명을 대상으로 혈청 AFP치를 측정하여 다음과 같은 결과를 얻었다. 1. 정상임산부 혈청 AFP치는 임신 8주에 가장 낮았으며, 임신 32주에서 최고치를 나타내었다. 2. 초산부와 경산부의 혈청 AFP평균치는 각각 $166.4{\pm}12.1ng/ml$, $223.8{\pm}14.0ng/ml$ 이었으며, 경산부가 초산부보다 혈청 AFP치가 통계적으로 의의있게 높았다(p<0.01). 3. 정상남아와 정상여아를 분만한 임산부의 혈청 AFP평균치는 각각 $193.0{\pm}13.0ng/ml$, $194.3{\pm}13.8ng/ml$이었으며, 정상남아를 분만한 임산부는 정상 여아를 분만한 임산부와 비교시 혈청 AFP치가 통계적으로 유의한 차이가 없었다(p>0.05). 4. 각 주수에 따른 정상 산모의 혈청 AFP는 표 3과 같다.

Alphafetoprotein(AFP) is a glycoprotein synthesized by the fetus early in gestation by the yolk sac and later by the gastrointestinal tract and liver. The concentration of AFP is highest in fetal serum and amniotic fluid around 13th week, and 32nd week in maternal serum. Some conditions are associated with abnormal maternal serum AFP concentration. For examples, neural tube defects, omphalocele, renal anomalies are associated with elevated maternal serum AFP and fetal death, chromosomal trisomies are associated with low level of maternal serum AFP. So maternal serum AFP screening plays a significant role in assessing candidates for prenatal diagnosis and prenatal counselling in pregnant women. This study evaluates the normal ranges of AFP using enzyme immunoassay in normal pregnant women. We studied 500 normal pregnant women who visited the Department of Obstetrics & Gynecology, Yeungnam Medical Center, Yeungnam University during the period through January, 1993 to September, 1996. The group of the study were selected randomly at various gestational ages from 8 to 41 weeks. The results were summarized as follows: 1. The lowest level of AFP in our study group was 2.1ng/ml at 8 weeks of gestation. Thereafter serum alpha-fetoprotein concentrations rose rapidly to reach a peak value at 32nd week. 2. The mean levels of AFP in the primipara and multipara were $166.37{\pm}12.06ng/ml$, and $223.78{\pm}14.00ng/ml$, respectively, showing stastiscally significant difference between these two groups(p<0.01). 3. The mean levels of AFP between mothers who delivered male and female babies were $192.96{\pm}13.00ng/ml$, and $194.29{\pm}13.84ng/ml$, respectively, without statistically significant difference(p>0.05). 4. The normal ranges of maternal serum AFP according to each gestational week were evaluated.