复发性流产患者血清RAGE、IL-35、VCAM-1变化及与预后相关性分析  

Analysis of changes of serum RAGE, IL-35 and VCAM-1 in patients with recurrent miscarriage and their correlation with prognosis

作　　者：曾彬[1] 于婉莹[1] 李翠[1] 梁雨[1] 张鸥[1] 樊桂玲[1] 韩宝生[1] Zeng Bin;Yu Wanying;Li Cui;Liang Yu;Zhang Ou;Fan Guiling;Han Baosheng(Tangshan Maternal and Child Health Care Hospital,Tangshan Hebei 063000,China)

机构地区：[1]河北省唐山市妇幼保健院,河北唐山063000

出　　处：《遵义医科大学学报》2020年第2期240-245,共6页Journal of Zunyi Medical University

基　　金：河北省2020年度医学科学研究课题计划资助项目(NO:20201471)。

摘　　要：目的探究复发性流产患者血清晚期糖基化终产物受体(RAGE)、白细胞介素-35(IL-35)、血管内皮细胞黏附分子-1(VCAM-1)变化及与预后相关性分析。方法选取2017年8月至2019年2月我院收治的53例复发性流产且出现先兆流产表现患者作为观察组,纳入68例正常妊娠者作为对照组。比较两组孕5~10周血清RAGE、IL-35、VCAM-1水平,随访所有患者至妊娠12周,统计保胎成功及失败患者血清各指标水平,Pearson分析血清各指标水平间及与预后关系,受试者工作曲线(ROC)分析血清各指标单纯及联合预测效能。结果①观察组孕5~6周、7~8周、9~10周血清RAGE高于对照组,IL-35、VCAM-1水平低于对照组(P<0.05);②孕7~8周三者联合预测复发性流产的曲线下面积(AUC)最大,为0.896(95%CI:0.827~0.944),预测敏感度及特异度为75.47%、95.35%;③观察组保胎成功者孕5~6周、7~8周、9~10周血清RAGE低于保胎失败者,IL-35、VCAM-1水平高于保胎失败者(P<0.05);④血清RAGE(r1=-0.612)与预后呈负相关,IL-35(r2=0.712)、VCAM-1(r3=0.801)与预后呈正相关(P均<0.05);⑤血清RAGE与IL-35(r1=0.645)、VCAM-1(r2=0.671)呈负相关,IL-35与VCAM-1(r3=-0.711)呈正相关(P均<0.05)。结论复发性流产患者血清RAGE、IL-35、VCAM-1水平异常与预后密切相关,有助于早期鉴别复发性流产,确定合理预防措施。Objective To investigate the changes of advanced glycation end product receptor(RAGE),interleukin-35(IL-35)and vascular endothelial cell adhesion molecule-1(VCAM-1)in the serum of patients with recurrent miscarriage and the correlation with prognosis.Methods A total of 53 patients with recurrent miscarriage and threatened abortion who were treated in Tangshan Maternal and Child Health Care Hospital from August,2017 to February,2019 were selected as observation group,while 68 cases of normal pregnancy were included as the control group.The levels of serum RAGE,IL-35 and VCAM-1 of pregnancy at 5~10 weeks in the two groups were compared.All patients were followed up to 12 weeks gestation and the serum levels of patients with successful and unpregnant pregnancy were counted.The relationship between the serum levels and prognosis was assessed by Pearson analysis.The receiver operating curve(ROC)was used to analyze the simple and combined predictive efficacy of serum levels.Results(1)The serum RAGE of the observation group at 5~6 weeks,7~8 weeks and 9~10 weeks was higher than that in the control group.The levels of IL-35 and VCAM-1 were lower than those in the control group.(2)The area under the curve(AUC)of the combined prediction of recurrent miscarriage at the 7~8 weeks of pregnancy was the largest with the number of 0.896(95%CI:0.827~0.944),and the predicted sensitivity and specificity were 75.47%and 95.35%,respectively.(3)In the observation group,those who succeeded in preserving pregnancy had lower serum RAGE than those who failed preservation at 5~6 weeks,7~8 weeks and 9~10 weeks and the levels of IL-35 and VCAM-1 were higher than those who failed preservation.(4)Serum RAGE(r 1=-0.612)was negatively correlated with prognosis,and IL-35(r 2=0.712)and VCAM-1(r 3=0.801)were positively correlated with prognosis.(5)Serum RAGE was negatively correlated with IL-35(r 1=0.645)and VCAM-1(r 2=0.671),and IL-35 was positively correlated with VCAM-1(r 3=-0.711).Conclusion Abnormal serum RAGE,IL-35 and VCAM-1 levels in patients

关 键 词：复发性流产 保胎成功 保胎失败 RAGE IL-35 VCAM-1 

分 类 号：R714.21[医药卫生—妇产科学]