血清sFlt-1、HSP70、IL-1受体拮抗剂在多囊卵巢综合征患者中的表达及对妊娠结局的影响  

Expression of serum soluble receptor 1,heat shock protein 70 and IL-1Ra in patients with polycystic ovary syndrome and their effect on pregnancy outcome

作　　者：李超平 时琼 白瑞平 马瑛 LI Chao-ping;SHI Qiong;BAI Rui-ping;MA Ying(Department of Obstetrics and Gynecology,Xihua maternal and child health hospital,Zhoukou 466600,Henan,China)

机构地区：[1]西华县妇幼保健院妇产科,河南周口466600

出　　处：《广东医学》2020年第14期1437-1441,共5页Guangdong Medical Journal

基　　金：河南省医学科技攻关计划项目(201812235)。

摘　　要：目的探讨血清内皮生长因子可溶性受体1(sFlt-1)、热休克蛋白70(HSP70)、白细胞介素-1受体拮抗剂(IL-1Ra)在多囊卵巢综合征(PCOS)患者中的表达及对妊娠结局的影响。方法选取PCOS患者81例作为观察组,另选取同期健康体检者85例作为对照组。收集两组临床资料,包括年龄、性生活史、合并高血压、体质指数(BMI)、血清黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T),并检测对比两组血清sFlt-1、HSP70、IL-1Ra水平,logistic回归分析PCOS发生的影响因素,受试者工作特征(ROC)曲线分析血清sFlt-1、HSP70、IL-1Ra对PCOS的诊断价值。此外,观察组均给予达英-35联合二甲双胍治疗,共治疗3个月经周期。比较不同妊娠结局患者血清sFlt-1、HSP70、IL-1Ra水平。结果观察组血清sFlt-1低于对照组,HSP70、IL-1Ra高于对照组(P<0.05);logistic回归显示:BMI、血清FSH、LH、T、sFlt-1、HSP70、IL-1Ra是PCOS发生的重要影响因素(P<0.05);ROC曲线分析显示,血清sFlt-1诊断AUC(0.874)>IL-1Ra(0.768)>HSP70(0.659),截断值≤262.37时,诊断敏感度为88.89%,特异度为77.65%;该三项指标的联合应用对PCOS诊断敏感度和特异度分别为90.12%(73/81)、90.58%(77/85),高于单独检测及两两联合检测。治疗3个月经周期后,血清sFlt-1高表达者妊娠率高于低表达者,HSP70、IL-1Ra高表达者妊娠率低于低表达者(P<0.05)。Logistic回归显示:血清sFlt-1、HSP70、IL-1Ra是妊娠结局的关联影响因素(P<0.05)。结论血清sFlt-1、HSP70、IL-1Ra在PCOS中呈异常表达,有助于PCOS的早期诊断,同时对妊娠结局的预测及治疗方案的制定均具有重要参考价值。Objective To investigate the expression of serum endothelial growth factor soluble receptor 1(sFlt-1),heat shock protein 70(HSP70),and interleukin-1 receptor antagonist(IL-1Ra)in patients with polycystic ovary syndrome(PCOS)and the effect on pregnancy outcome.Methods Eighty-one cases of PCOS treated in our hospital from January 2016 to December 2018 were selected as the observation group,and 85 non-pregnant females who underwent healthy physical examination during the same period were selected as the control group.The clinical data of two groups were collected,including age,sexual life history,combined hypertension,body mass index(BMI),serum luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T),and the serum levels of sFlt-1,HSP70,and IL-1Ra were measured and compared.Logistic regression was used to analyze the influencing factors of PCOS,and the receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum sFlt-1,HSP70,and IL-1Ra for PCOS.In addition,the observation group were all treated with Daying-35 combined with metformin for a total of 3 menstrual cycles.The serum levels of sFlt-1,HSP70 and IL-1Ra in patients with different pregnancy outcomes were compared.Results The serum sFlt-1 in the observation group was significantly lower than that in the control group,and HSP70 and IL-1Ra were higher than the control group(P<0.05).Logistic regression showed that BMI,serum FSH,LH,T,sFlt-1,HSP70,and IL-1Ra were important influencing factors of PCOS(P<0.05);ROC curve analysis showed AUC diagnosed by serum sFlt-1(0.874)was superior than IL-1Ra(0.768)and HSP70(0.659);when the cutoff value was≤262.37,the diagnostic sensitivity was 88.89%and the specificity was 77.65%.The combined application of these three indicators had higher diagnostic value for the PCOS,with the sensitivity and specificity of 90.12%and 90.58%,respectively;and higher than single detection and pairwise detection.After 3 menstrual cycles of treatment,the pregnancy rate of those with high serum sFlt-1

关 键 词：多囊卵巢综合征 SFLT-1 HSP70 IL-1RA 妊娠结局 

分 类 号：R711.7[医药卫生—妇产科学] R588.6[医药卫生—临床医学]