摘要
目的:探讨不同心功能分级妊娠晚期合并心脏病产妇与正常产妇纤溶酶原激活物抑制剂-1(PAI-1)、血管细胞粘附分子-1(VCAM-1)水平间的差异,为临床提供参考。方法:回顾性分析2020年10月—2022年1月南阳医学高等专科学校第一附属医院妇产科收治的137例妊娠晚期产妇的临床资料,按心功能分级标准将其中100例合并心脏病产妇分为两组,Ⅰ~Ⅱ级为低风险组,Ⅲ~Ⅳ级为高风险组,每组各50例,另选取同期正常妊娠产妇37例,作为对照组。比较三组产妇PAI-1、VCAM-1水平间的差异,经受试者工作特征(ROC)曲线下面积(AUC)验证不同心功能分级与PAI-1、VCAM-1水平的相关性,并对所有产妇进行分娩后3个月随访,统计三组产妇的妊娠结局和母婴结局。结果:与低风险组产妇相比,高风险组产妇的PAI-1、VCAM-1水平更高,对照组更低,差异有统计学意义(F=323.03、5662.07,P<0.05)。经ROC验证结果显示,PAI-1、VCAM-1水平与低风险、高风险组内产妇心功能分级呈正相关,低风险组对应的AUC分别为0.945、0.943,高风险组对应的AUC分别为0.919、0.921。高风险组的自然分娩率较低风险组、对照组更低,差异有统计学意义(χ^(2)=52.780,P<0.05)。随访3个月内,高风险组的产妇死亡率以及新生儿死亡率较低风险组、对照组更高,差异有统计学意义(χ^(2)=0.759、12.245,P<0.05)结论:PAI-1、VCAM-1水平与妊娠晚期合并心脏病产妇的心功能分级呈正相关,心功能分级越高对应的指标水平越高,通过动态监测合并心脏病产妇的PAI-1、VCAM-1水平可有效改善其不良妊娠结局及母婴结局。
Objective:To investigate the differences between the levels of fibrinogen activator inhibitor-1(PAI-1)and vascular cell adhesion molecule-1(VCAM-1)in pregnant women with heart disease and normal women with different grades of cardiac function,and to provide a clinical reference.Methods:The clinical data of 137 cases of late pregnancy admitted to the obstetrics and gynecology department of the hospital from October 2020 to January 2022 were retrospectively analyzed.The 100 women with combined heart disease were divided into two groups according to the cardiac function grading criteria,with grade I-II being the low-risk group and grade III-IV being the high-risk group,with 50 cases in each group,and 37 normal pregnant women who came to the hospital for examination at the same time were selected as the control group.The differences between maternal PAI-1 and VCAM-1 levels in the three groups were compared.The correlation between different cardiac function classes and PAI-1 and VCAM-1 levels was verified by the area under the subject work characteristic(ROC)curve(AUC).All women were followed up at 3 months after delivery,and pregnancy outcomes and maternal and infant outcomes were counted in the three groups.Results:Maternal PAI-1 and VCAM-1 levels were higher in the high-risk group and lower in the control group compared to the low-risk group,with statistically significant differences(F=323.03,5662.07,P<0.05).The results of ROC validation showed that PAI-1 and VCAM-1 levels were positively correlated with maternal cardiac function grading in the low-and high-risk groups,with corresponding AUCs of 0.945 and 0.943 in the low-risk group and 0.919 and 0.921 in the high-risk group,respectively.The natural childbirth rate in the high-risk group were lower compared with the low-risk and cotrlo groups,with statistically significant difference(χ^(2)=52.780,P<0.05)Maternal mortality and neonatal mortality were higher in the high-risk group compared with the low-risk and control groups within 3 months of follow-up,with statis
作者
龚晓雪
黄雪梅
Gong Xiaoxue;Huang Xuemei(Department of Obstetrics and Gynecology,The First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan,473000,China)
出处
《黑龙江医学》
2023年第21期2572-2575,共4页
Heilongjiang Medical Journal
基金
河南省医学教育研究项目(201811029)。
关键词
妊娠晚期合并心脏病
纤溶酶原激活物抑制剂-1
血管细胞粘附分子-1
妊娠结局
母婴结局
Combined heart disease in late pregnancy
Fibrinogen activator inhibitor-1
Vascular cell adhesion molecule-1
Pregnancy outcome
Maternal-infant outcome
