摘要
目的探讨外周血中炎症指标与胚胎停育及先兆流产之间的相关性。方法采用回顾性病例对照研究,选取于2021年12月—2022年5月在四川大学华西第二医院诊断为胚胎停育孕妇53例为胚胎停育组,先兆流产孕妇48例为先兆流产组,同期健康妊娠孕妇50例为正常对照组。收集各组临床资料和外周血中血清淀粉样蛋白A(SAA),白细胞介素6(IL-6),中性粒细胞与淋巴细胞比值(NLR)等指标,分析比较各指标之间的差异;多元logistics回归进行危险因素分析;采用受试者工作特征曲线(ROC)确立上述指标对于胚胎停育及先兆流产的诊断预测价值。结果胚胎停育组SAA和NLR水平显著高于正常妊娠组(均P<0.05);先兆流产组IL-6和NLR水平明显高于正常妊娠组(均P<0.05)。多元logistics回归分析显示,NLR、IL-6是胚胎停育的危险因素(P<0.05);NLR、IL-6也是先兆流产的危险因素(P<0.05)。炎症指标SAA、IL-6和NLR水平预测胚胎停育的ROC曲线下面积分别为0.720、0.566、0.710;预测先兆流产的ROC曲线下面积0.537、0.792、0.808。结论外周血中炎症指标SAA和NLR对胚胎停育的早期预测有一定的参考价值,IL-6和NLR对先兆流产的早期预测有一定的参考价值。
Objective To explore the correlation between inflammatory indicators in peripheral blood and embryo suspension and threatened abortion.Methods A retrospective case-control study was conducted to select 53 pregnant women with embryo suspension,48 pregnant women with threatened abortion and 50 pregnant women with normal pregnancy as the normal control group in the West China Second Hospital of Sichuan University from December 2021 to May 2022.Clinical data and Serum amyloid A(SAA),interleukin-6(IL-6),and neutrophil lymphocyte ratio(NLR)were collected,and the differences of indicators were analyzed and compared.Multiple logistic regression was used to analyze the risk factors.The receiver operating characteristic curve(ROC)was used to establish the predictive value of the indexes for embryo suspension and threatened abortion.Results The levels of SAA and NLR in embryo suspension group were significantly higher than those in normal pregnancy group(P<0.05);The levels of IL-6 and NLR in threatened abortion group were significantly higher than those in normal pregnancy group(P<0.05).Multiple logistic regression analysis showed that NLR(OR=2.656,95%CI:1.464~3.847)and IL-6(OR=19.136,95%CI:1.556~36.716)were the risk factors of embryo suspension(P<0.05);NLR(OR=3.336,95%CI:1.785~4.886)and IL-6(OR=22.128,95%CI:1.794~42.463)were the risk factors of threatened abortion(P<0.05).The areas under the ROC curve predicted by the levels of inflammatory indexes SAA,IL-6 and NLR were 0.720,0.566 and 0.710,respectively;The area under ROC curve for predicting threatened abortion was 0.537,0.792 and 0.808.Conclusion The inflammatory indexes SAA and NLR in peripheral blood have reference value for early prediction of embryo abortion,and IL-6 and NLR have reference value for early prediction of threatened abortion.
作者
李瑞英
周岩
黄祖路
于凡
刘小娟
LI Ruiying;ZHOU Yan;HUANG Zulu;YU Fan;LIU Xiaojuan(Department of Laboratory Medicine,West China Second Hospital,Sichuan,Chengdu 610041,China;Key Laboratory of Birth Defects and Related Diseases of Women and Children,Sichuan University,Ministry of Education,Chengdu 610041,China;Dujiangyan Maternal and Child Health Care Hospital,Chengdu 611800,China)
出处
《西部医学》
2023年第5期687-691,共5页
Medical Journal of West China
基金
四川省卫生健康委员会项目(20PJ076)。
