摘要
目的探究血清基质金属蛋白酶-9(MMP-9)、白细胞介素-35(IL-35)对瘢痕子宫妊娠孕妇妊娠结局的预测价值,为降低瘢痕子宫妊娠孕妇发生不良妊娠结局概率提供理论支持。方法选取武安市第一人民医院2020年10月-2022年3月接诊的106例瘢痕子宫妊娠孕妇为疾病组,根据妊娠结局将其分为良好组(n=79)和不良组(n=27),同时选择同期产检的正常子宫孕妇为对照组(n=106)。采用ELISA法测定血清MMP-9、IL-35表达水平,多因素logistic回归分析瘢痕子宫妊娠孕妇发生不良妊娠结局的影响因素;运用受试者工作特征(ROC)曲线评估血清MMP-9、IL-35水平对瘢痕子宫妊娠孕妇发生不良妊娠结局的预测价值。结果疾病组血清MMP-9水平(367.80±45.51)μg/L高于对照组(311.15±42.57)μg/L,IL-35水平(301.65±39.69)pg/mL低于对照组(343.28±46.13)pg/mL,差异均有统计学意义(t=9.359、7.043,P均<0.05)。不良组血清MMP-9水平(425.17±53.28)μg/L明显高于良好组(348.19±42.86)μg/L,子宫下段厚度(3.11±0.46)mm、血清IL-35水平(269.75±29.17)pg/mL明显低于良好组(4.33±0.75)mm、(312.55±43.28)pg/mL,差异均有统计学意义(t=7.558、7.943、4.774,P均<0.05)。子宫下段厚度、血清MMP-9、IL-35水平是影响瘢痕子宫妊娠孕妇发生不良妊娠结局的相关因素(P均<0.05)。血清MMP-9、IL-35及二者联合预测瘢痕子宫妊娠孕妇发生不良妊娠结局的曲线下面积分别为0.902(95%CI:0.829~0.951)、0.821(95%CI:0.734~0.888)、0.963(95%CI:0.907~0.990),二者联合优于单独预测(Z_(联合vs.MMP-9)=2.331,P=0.020;Z_(联合vs.IL-35)=3.086,P=0.002)。结论瘢痕子宫妊娠孕妇和不良妊娠结局孕妇血清MMP-9水平明显升高,血清IL-35水平明显降低,二者联合对瘢痕子宫妊娠孕妇发生不良妊娠结局有更高的预测价值。
Objective To explore the predictive value of serum matrix metalloproteinase⁃9(MMP⁃9)and interleukin⁃35(IL⁃35)on the pregnancy outcomes of pregnant women with scar uterus pregnancy.Methods A total of 106 pregnant women with scar uterine pregnancy who visited the First People's Hospital of Wu'an City from October 2020 to March 2022 were collected as the disease group.According to the pregnancy outcome,they were separated into a good group(n=79)and an adverse group(n=27).Normal pregnant women who underwent prenatal examination in our hospital were regarded as the reference group(n=106).ELISA method was applied to measure the expression levels of MMP⁃9 and IL⁃35 in serum,multivariate logistic regression was applied to analyze the influencing factors of adverse pregnancy outcomes in pregnant women with scar uterus pregnancy;receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of serum MMP⁃9 and IL⁃35 levels for adverse pregnancy outcomes in pregnant women with scar uterus pregnancy.Results The serum MMP⁃9 expression(367.80±45.51)μg/L level in the disease group was obviously higher than that in the reference group(311.15±42.57)μg/L,while the serum IL⁃35 expression(301.65±39.69)pg/mL level was obviously lower than that in the reference group(343.28±46.13)pg/mL,the differences were statistically significant(t=9.359,7.043;all P<0.05);the serum MMP⁃9 level(425.17±53.28)μg/L in the adverse group were obviously higher than those in the good group(348.19±42.86)μg/L,while the thickness of the lower uterine segment(3.11±0.46)mm and serum IL⁃35 level(269.75±29.17)pg/mL were obviously lower than those in the good group(4.33±0.75)mm,(312.55±43.28)pg/mL,the differences were statistically significant(t=7.558,7.943,4.774;all P<0.05);the thickness of the lower uterine segment,serum MMP⁃9,and IL⁃35 levels were related factors that affected the occurrence of adverse pregnancy outcomes in pregnant women with scar uterus pregnancy(P<0.05);the area under the curv
作者
韩慧娟
郭丽君
陈晓丹
HAN Huijuan;GUO Lijun;CHEN Xiaodan(Department of Obstetrics,the First People's Hospital of Wu'an City,Handan,Hebei 056300,China)
出处
《热带医学杂志》
CAS
2024年第4期513-517,F0003,共6页
Journal of Tropical Medicine
基金
河北省医学科学研究计划(20201559)。
