文章摘要
李超平,马瑛,时琼,等.血清孕酮、转化生长因子 -β、共刺激分子可溶性 B7-H3在自发性流产病人中的表达及预测价值分析[J].安徽医药,2021,25(6):1173-1177.
血清孕酮、转化生长因子 -β、共刺激分子可溶性 B7-H3在自发性流产病人中的表达及预测价值分析
Expression and predictive value of serum progesterone, TGF-β and sB7-H3 in patients with spontaneous abortion
  
DOI:10.3969/j.issn.1009-6469.2021.06.028
中文关键词: 流产,自然  孕酮  转化生长因子 -β  妊娠结局  受试者工作特征曲线  共刺激分子可溶性 B7-H3
英文关键词: Abortion, spontaneous  Progesterone  Transforming growth factor-β  Pregnancy outcome  Receiver operating
基金项目:
作者单位
李超平 西华县妇幼保健院妇产科河南周口 466600 
马瑛 西华县妇幼保健院妇产科河南周口 466600 
时琼 西华县妇幼保健院妇产科河南周口 466600 
白瑞平 西华县妇幼保健院妇产科河南周口 466600 
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中文摘要:
      目的探讨血清孕酮、转化生长因子 -β(TGF-β)、共刺激分子可溶性 B7-H3(sB7-H3)在自发性流产( SA)病人中的表达及预测价值。方法选取周口市西华县妇幼保健院 2015年 5月至 2018年 1月妊娠者 240例作为研究对象,根据妊娠情况分为 SA病人 35例作为观察组,正常妊娠者 205例作为对照组。妊娠第 6周、第 7周、第 10周、第 12周检测对比两组血清孕酮、 TGFβ、sB7-H3水平, logistic回归分析 SA影响因素, Pearson相关系数分析血清孕酮、 TGF-β、sB7-H3间相关性,受试者工作特征曲线(ROC曲线)分析血清孕酮、 TGF-β、sB7-H3对 SA的预测价值。结果两组年龄、既往流产史、甲状腺功能差异有统计学意义(P <0.05);观察组妊娠第 7周、第 10周、第 12周孕酮( 26.38±4.12)μg/L、(28.13±5.66)μg/L、(30.16±6.16)μg/L、TGF-β(4 407.60± 710.38)ng/L、(5 801.20±953.25)ng/L、(6 531.52±1,280.92)ng/L、sB7-H3(901.52±250.56)ng/L、(1 308.27±339.78)ng/L、(1 718.03±417.38)ng/L水平低于对照组( 29.84±5.28)μg/L、(33.29±6.38)μg/L、(38.95±8.88)μg/L、(5 151.07±780.19)ng/L、(6 776.44±995.61)ng/L、(8 032.10±1 500.17)ng/L、(1 176.17±281.44)ng/L、(1 675.91±378.75)ng/L、(2 183.08±470.18)ng/L(P<0.05);年龄 ≥30岁、既往流产史、甲状腺功能异常、血清孕酮、 TGF-β、sB7-H3是 SA发生的独立危险因素( P<0.05);血清 TGF-β与 sB7-H3呈正相关,孕酮与 TGF-β、sB7-H3呈正相关( P<0.05); ROC曲线显示,第 7周血清孕酮预测 SA的 AUC值最高 0.864,大于 TGF-β、sB7-H3。结论 SA病人血清孕酮、 TGF-β、sB7-H3呈低表达,因子间协同作用可能是造成流产的主要原因,临床加强高危 SA病人上述因子监测,对超早期干预、改善妊娠结局具有重要意义。
英文摘要:
      Objective To investigate the expression and predictive value of serum progesterone (P), transforming growth factor-β (TGF-β) and costimulatory molecule soluble B7-H3 (sB7-H3) in patients with spontaneous abortion (SA).Methods A total of 240 cases of pregnant women in The Xihua County Maternal and Child Health Hospital of Zhoukou City from May 2015 to January 2018 wereselected as the research objects. According to the pregnancy status, 35 cases with SA were used as the observation group, and 205 cases with normal pregnancy were used as the control group. The levels of serum P, TGF-β and sB7-H3 in the two groups were measuredand compared at the sixth, seventh, tenth, twelfth weeks of pregnancy, logistic regression was used to analyze SA influencing factors,Pearson correlation coefficient was used to analyze the correlation among serum P, TGF-β and sB7-H3, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum P, TGF-β and sB7-H3 to SA.Results The differences in age, previous miscarriage history, and thyroid function between the two groups were statistically significant (P<0.05); P level in the observation group was (26.38±4.12) μg/L, (28.13±5.66) μg/L and (30.16±6.16) μg/L, respectively at the 7th, 10th, and 12th week of pregnancy, TGF-β level was (4 407.60±710.38) ng/L, (5 801.20±953.25) ng/L and (6 531.52±1 280.92) ng/L respectively, sB7-H3 level was (901.52±250.56) ) ng/L, (1 308.27±339.78) ng/L, (1 718.03±417.38) ng/L, which were lower than those in the control group [P level:(29.84±5.28) μg/L, (33.29±6.38) μg/L and (38.95±8.88) μg/L, respectively; TGF-β level: (5 151.07±780.19)ng/L, (6 776.44±995.61) ng/L and (8 032.10±1 500.17)ng/L, respectively; sB7-H3 level (1 176.17±281.44)ng/L, (1 675.91±378.75)ng/L and ( 2 183.08±470.18) ng/L , respectively] (P<0.05); age≥30 years old, history of miscarriage, abnormal thyroid function, serum P, TGF-β, and sB7-H3 were independent risk factors for SA (P<0.05); serum TGF-β was positively correlated with sB7-H3, and P was positively correlated with TGF-β and sB7-H3 (P<0.05); ROC curve showed that the AUC value of serum P predicted SA at week 7 was the highest 0.864, which was greater than TGF-β, sB7 -H3.Conclusion There are abnormal expression of P, TGF-β and sB7-H3 in patients with SA, the syner gism among factors may be the main cause of abortion, it is of great significance to strengthen the clinical monitoring of the above factors in high-risk patients with SA for ultra-early intervention and improvement of pregnancy outcomes.
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