| 林红莲,赵惠.磁共振成像评分及血清 GPX1、TAZ水平与前置胎盘病人胎盘植入程度关系及对妊娠结局的预测价值[J].安徽医药,2026,30(8):1571-1576. |
| 磁共振成像评分及血清 GPX1、TAZ水平与前置胎盘病人胎盘植入程度关系及对妊娠结局的预测价值 |
| Relationship between MRI score, serum GPX1, TAZ levels and placenta implantation degree in placenta previa patients and the predictive value of pregnancy outcome |
| |
| DOI：10.3969/j.issn.1009-6469.2026.08.017 |
| 中文关键词: 前置胎盘 胎盘植入 磁共振成像 谷胱甘肽过氧化物酶 1 转录共激活因子 PDZ结合基序 妊娠结局 |
| 英文关键词: Placenta previa Placental implantation Magnetic resonance imaging Glutathione peroxidase 1 Transcriptional coactivator PDZ-binding motif Pregnancy outcome |
| 基金项目:新疆维吾尔自治区自然科学基金项目( 2019D12C125) |
|
| 摘要点击次数: 195 |
| 全文下载次数: 26 |
| 中文摘要: |
| 目的探讨磁共振成像( MRI)评分及血清谷胱甘肽过氧化物酶 1(GPX1)、转录共激活因子 PDZ结合基序( TAZ)与前置胎盘病人胎盘植入程度关系及对妊娠结局的预测价值。方法前瞻性选取 2020年 1月至 2023年 12月新疆巴州人民医院收治的 152例前置胎盘病人作为研究组，另按照 1∶1纳入同期 152例健康体检孕妇作为健康组。比较两组入院时 MRI评分及血清 GPX1、TAZ mRNA表达， Spearman分析 MRI评分及血清 GPX1、TAZ mRNA与胎盘植入程度相关性，后根据研究组妊娠结局分为不良亚组和良好亚组，采用单、多因素分析前置胎盘病人不良妊娠结局影响因素，绘制受试者操作特征曲线( ROC曲线)及曲线下面积( AUC)分析 MRI评分及血清 GPX1、TAZ mRNA预测前置胎盘病人不良妊娠结局价值， Delong检验 AUC差异。结果研究组植入型 /穿透型 MRI评分 >粘连型 >阴性， GPX1、TAZ mRNA表达 <粘连型 <阴性 <健康组( P<0.05)。胎盘植入病人 MRI评分与胎盘植入程度成正比，血清 GPX1、TAZ mRNA表达与植入程度成反比( P<0.05)。研究组所有病人均随访至妊娠结束 1个月，不良妊娠结局发生率为 34.87%。不良亚组胎盘植入程度 -植入型 /穿透型所占比例、剖宫产史、 MRI评分高于良好亚组，不良亚组血清 GPX1表达、 TAZ mRNA表达为［(25.51±8.40)U/L、2.11±1.03］均低于良好亚组［(36.96±9.28)U/L、4.46±1.39］(P<0.05)。胎盘植入程度［ OR=1.47，95%CI:(1.00，2.14)］、剖宫产史［ OR=1.94，9，5%CI:(1.25，3.02)］、 MRI评分［ OR=1.64， 95%CI:(1.10，2.46)］、 GPX1［OR=0.69，95%CI:(0.67，0.71)］、 TAZ mRNA［OR=0.70，95%CI:(0.69，0.70)］是前置胎盘病人不良妊娠结局影响因素( P<0.05)。 MRI评分及血清 GPX1、TAZ mRNA联合预测前置胎盘病人不良妊娠结局 AUC为 0.92，优于单一MRI评分、 GPX1、TAZ mRNA的 AUC分别为 0.81、0.78、0.82。MRI及 GPX1、TAZ mRNA的检测费用分别为 800、1 000、500元，成本效益分析分别为 11.16、12.33、6.80。结论前置胎盘病人胎盘植入程度与 MRI评分及血清 GPX1、TAZ mRNA表达显著相关，成本效益比值低，联合检测可显著提高妊娠结局预测价值，指导临床诊治，改善妊娠结局。 |
| 英文摘要: |
| Objective To investigate the relationship between magnetic resonance imaging (MRI) scores, serum glutathione peroxi-dase 1 (GPX1), transcriptional coactivator PDZ-binding motif (TAZ) and placental implantation degree in patients with placenta previaand the predictive value of pregnancy outcomes.Methods Prospective selection of 152 patients with placenta previa admitted to Ba-zhou People`s Hospital in Xinjiang from January 2020 to December 2023 were selected as the study group, another 152 healthy preg-nant women in the same period were included as the healthy group according to 1:1 ratio. MRI scores and serum GPX1 and TAZ mRNAexpressions were compared between the two groups at admission, and the correlation between MRI scores and serum GPX1 and TAZmRNA and placental implantation degree was analyzed by Spearman. The study group was then divided into poor subgroup and goodsubgroup according to pregnancy outcomes, single and multiple factors were used to analyze the influencing factors of adverse pregnan-cy outcomes in placenta previa patients, the receiver operating characteristic curve (ROC curve) and area under the curve (AUC) weredrawn to analyze the value of MRI score and serum GPX1 and TAZ mRNA in predicting adverse pregnancy outcomes in patients withplacenta previa, and the AUC difference was tested by Delong.Results The implantable/penetrating MRI scores of the study groupwere > adhesion > negative, and the mRNA expressions of GPX1 and TAZ were < adhesion < negative < healthy group (P<0.05). MRIscores of patients with placenta implantation were proportional to the degree of placenta implantation, and serum GPX1 and TAZmRNA expressions were inversely proportional to the degree of placenta implantation (P<0.05). All patients in the study group were fol-lowed up to 1 month after the end of pregnancy, and the incidence of adverse pregnancy outcomes was 34.87%. The proportion of pla-centa implantation degree-implantation type/penetrating type, cesarean section history and MRI score in the poor subgroup were higherthan those in the good subgroup, the serum GPX1 expression and TAZ mRNA expression in the poor subgroup were [(25.51±8.40) U/Land 2.11±1.03], which were lower than those in the good subgroup [(36.96±9.28) U/L and 4.46±1.39] (P<0.05). The degree of placenta implantation [OR=1.47, 95%CI: (1.00,2.14)], history of cesarean section [OR=1.94, 95%CI: (1.25,3.02)], MRI score [OR=1.64, 95%CI: (1.10,2.46)], GPX1 [OR=0.69, 95%CI: (0.67,0.71)], and TAZ mRNA [OR=0.70, 95%CI: (0.69,0.70)] were factors that affect the adverse pregnancy outcomes in patients with placenta previa (P<0.05). The AUC of MRI score combined with serum GPX1 and TAZ mRNA inpredicting adverse pregnancy outcomes in patients with placenta previa was 0.92, which was better than 0.81, 0.78 and 0.82 of MRIscore, GPX1 and TAZ mRNA alone. The costs of MRI, GPX1, and TAZ mRNA detection were 800, 1 000, and 500 yuan, respectively,and the cost-effectiveness analysis was 11.16, 12.33, and 6.80, respectively.Conclusions The degree of placenta implantation in pa-tients with placenta previa is significantly correlated with MRI scores and the expression of serum GPX1 and TAZ mRNA. The cost-benefit ratio is low, and combined detection can significantly improve the predictive value of pregnancy outcomes, guide clinical diagno-sis and treatment, and improve pregnancy outcomes. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
