摘要
目的 探讨复发性流产血栓前状态(PTS-RSA)孕妇血清脑钠肽(BNP)、抗凝血酶-Ⅲ(ATⅢ)、抗β2-糖蛋白Ⅰ抗体(Anti-β2-GPI)水平对疾病转归的预测价值。方法 选取PTS-RSA孕妇136例为观察组,选取同期RSA但不伴PTS孕妇68例为对照1组,正常孕妇68例为对照2组。检测三组血清BNP、ATⅢ、Anti-β2-GPI水平,对比观察组治疗前后血清BNP、ATⅢ、Anti-β2-GPI水平,采用logistic回归模型分析PTS-RSA孕妇保胎失败的影响因素,采用受试者操作特征(ROC)曲线及曲线下面积(AUC)分析BNP、ATⅢ、Anti-β2-GPI预测保胎失败的价值。结果 观察组治疗前血清BNP、Anti-β2-GPI高于对照1组、对照2组,对照1组高于对照2组(P<0.05);观察组治疗前血清ATⅢ水平低于对照1组,对照1组低于对照2组(P<0.05);观察组治疗后血清BNP、Anti-β2-GPI低于治疗前,ATⅢ水平高于治疗前(P<0.05);调整年龄、流产次数、饮酒史、月经情况、孕前调理后,治疗前后BNP、ATⅢ、Anti-β2-GPI水平仍与保胎失败有关(P<0.05);治疗后血清BNP、ATⅢ、Anti-β2-GPI水平联合预测保胎失败的AUC最大,为0.833。结论 BNP、ATⅢ、Anti-β2-GPI的表达与PTS-RSA的发生、转归有关,通过检测上述指标水平有助于预测孕妇保胎情况,指导临床调整治疗方案。
Objective To evaluate the predictive value of serum brain natriuretic peptide(BNP),antithrombin-II(AT Ⅲ)and anti-β2-glycoprotein I antibody(Anti-β2-GPI)levels in patients with recurrent spontaneous abortion prethrombotic state(PTS-RSA).MethodIssOne hundred and thirty-six pregnant women with PTS-RSA were selected as the observation group;68 pregnant women with RSA but no PTS during the same period were selected as the control group l;and 68 normal pregnant women were selected as the control group 2.The serum BNP,AT Ⅲ,and Anti-β2-GPI levels were assessed in the three groups.The serum BNP,AT Ⅲ,and Anti-β2-GPI levels before and after treatment in the observation group were compared.Logistic regression model was used to analyze the influencing factors of PTS-RSA pregnancy failure.The receiver operating characteristic curve(ROC)and area under the curve(AUC)were used to analyze the value of BNP,AT Ⅲ,Anti-β2-GPI in predicting the failure of pregnancy.Results The serum BNP and Anti-β2-GPI of the observation group before treatment were significantly higher than those of the control group 1 and the control group 2;and the control group 1 were significantly higher than the control group 2(P<0.05).The serum AT Ⅲ level of the observation group was significantly lower than the control group 1;and the control group 1 was significantly lower than the control group 2(P<0.05).Serum BNP and Anti-β2-GPI in the observation group after treatment were significantly lower than before treatment,and the level of AT Ⅲ was significantly higher than before treatment(P<0.05).After adjusting age,number of abortions,drinking history,menstruation,pre-pregnancy conditioning,BNP,AT Ⅲ,and Anti-β2-GPI levels before and after treatment were still correlated to the failure of pregnancy loss(P<0.05).The AUC of the combined prediction of BNP,AT Ⅲ,and Anti-β2-GPI levels for predicting pregnancy failure after treatment was the largest,which was 0.833.Conclusion The expression of BNP,AT Ⅲ,Anti-β2-GPI are correlated to the occurrence and outcome of PTS-RSA.The detection of the above-mentioned index levels can help predict pregnant women's fetal preservation and guide clinical adjustment of treatment plans.
作者
林建丽
李慧
吴小妹
周玉华
马燕琳
LIN Jian-li;LI Hui;WU Xiao-mei;ZHOU Yu-hua;MA Yan-lin(Department of Obstetrics,First Afiliated Hospital of Hainan Medical College,Haikou 570100,Hainan,China)
出处
《广东医学》
CAS
2023年第5期596-601,共6页
Guangdong Medical Journal
基金
海南省重大科技计划项目(ZDKJ2017007)。
关键词
BNP
ATⅢ
复发性流产
血栓
受试者操作特征曲线
I]brain natriuretic peptide
antithrombin-Ⅲ
recurrent miscarriage
prethrombotic
receiver operating characteristic curve
