血清Sestrin2、Resistin水平与妊娠晚期胎盘早剥及其预后的关系  

The relationship between serum Sestrin2 and Resistin levels and placental abruption in late pregnancy and its prognosis

作　　者：严晓瑞 赵贵 王小玉 张蓉蓉 Yan Xiaorui;Zhao Gui;Wang Xiaoyu;Zhang Rongrong(Department of Obstetrics and Gynecology,Lu'an Hospital Affiliated to Anhui Medical University/Lu'an People's Hospital,Anhui Province,Lu'an 237000,China)

机构地区：[1]安徽医科大学附属六安医院/六安市人民医院妇产科,237000

出　　处：《疑难病杂志》2022年第8期789-793,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：安徽省自然科学基金项目(1808085QH284)。

摘　　要：目的分析血清Sestrin2、抵抗素(Resistin)水平与妊娠晚期胎盘早剥(PA)及其预后的关系。方法选取2018年9月-2021年12月于安徽医科大学附属六安医院分娩的妊娠晚期PA孕妇90例作为PA组,再根据妊娠结局分为不良预后亚组48例和良好预后亚组42例,并选取同期正常分娩的妊娠晚期孕妇90例作为正常分娩组。比较2组和PA不同妊娠结局亚组临床资料及血清Sestrin2、Resistin水平。Logistic回归分析妊娠晚期PA孕妇发生不良妊娠结局的影响因素;受试者工作特征曲线(ROC)评估血清Sestrin2、Resistin水平对妊娠晚期PA孕妇发生不良妊娠结局的预测价值。结果PA组孕妇胎膜早破、妊娠期高血压疾病(HDCP)、妊娠期糖尿病(GDM)、机械损伤、羊水过多比例及血清Sestrin2、Resistin水平明显高于正常分娩组[χ^(2)(t)/P=41.180/<0.001、4.808/0.028、4.367/0.037、6.197/0.013、4.655/0.031、12.230/<0.001、12.672/<0.001];不良预后亚组孕妇胎膜早破、HDCP、GDM、机械损伤、羊水过多比例及血清Sestrin2、Resistin水平明显高于良好预后亚组[χ^(2)(t)/P=26.498/<0.001、5.727/0.017、6.509/0.011、4.533/0.033、6.494/0.011、3.358/0.001、5.355/<0.001]。Logistic回归分析结果表明胎膜早破、HDCP、GDM、机械损伤、羊水过多及血清Sestrin2高、血清Resistin高均是影响妊娠晚期PA孕妇发生不良妊娠结局的危险因素[OR(95%CI)=2.403(1.577~3.662)、2.691(1.711~4.232)、2.272(1.526~3.822)、2.586(1.670~4.004)、2.359(1.563~3.560)、2.983(1.831~4.860)、2.785(1.754~4.423)];血清Sestrin2、Resistin及两者联合预测妊娠晚期PA孕妇发生不良妊娠结局的曲线下面积(AUC)分别为0.869、0.866、0.950,两者联合预测的AUC高于单项预测(Z=2.410、2.499,P=0.016、0.012)。结论妊娠晚期PA孕妇血清Sestrin2、Resistin水平较高,均与不良妊娠结局密切相关,两者联合可提高预测妊娠晚期PA孕妇妊娠结局不良的价值。Objective To analyze the relationship between serum Sestrin2 and Resistin levels and placental abruption(PA)in late pregnancy and its prognosis.Methods A total of 90 pregnant women with PA in the third trimester who birthed in Lu'an Hospital Affiliated to Anhui Medical University from September 2018 to December 2021 were selected as the PA group,and then divided into a poor prognosis subgroup of 48 cases and a good prognosis subgroup of 42 cases according to pregnancy outcomes.And 90 pregnant women in the third trimester of pregnancy who gave birth normally during the same period were selected as the normal delivery group.The clinical data and serum Sestrin2 and Resistin levels were compared between the two groups and the PA subgroups with different pregnancy outcomes.Logistic regression analysis was used to analyze the influencing factors of adverse pregnancy outcomes in pregnant women with PA in the third trimester;receiver operating characteristic curve(ROC)was used to evaluate the predictive value of serum Sestrin2 and Resistin levels on adverse pregnancy outcomes in pregnant women with PA in the third trimester.Results Premature rupture of membranes,pregnancy-induced hypertension(HDCP),gestational diabetes mellitus(GDM),mechanical injury,polyhydramnios and serum Sestrin2 and Resistin levels in the PA group were significantly higher than those in the normal delivery group[χ^(2)(t)/P=41.180/<0.001,4.808/0.028,4.367/0.037,6.197/0.013,4.655/0.031,12.230/<0.001,12.672/<0.001];poor prognosis subgroups of pregnant women with premature rupture of membranes,HDCP,GDM,mechanical injury,The proportion of polyhydramnios and serum Sestrin2 and Resistin levels were significantly higher than those in the good prognosis subgroup[χ^(2)(t)/P=26.498/<0.001,5.727/0.017,6.509/0.011,4.533/0.033,6.494/0.011,3.358/0.001,5.355/<0.001].Logistic regression analysis showed that premature rupture of membranes,HDCP,GDM,mechanical injury,polyhydramnios,high serum Sestrin2,and high serum Resistin were all risk factors for adverse pregnanc

关 键 词：胎盘早剥 Sestrin2 抵抗素 妊娠晚期 预后 

分 类 号：R714.2[医药卫生—妇产科学]