TLR4信号通路预测多囊卵巢综合征合并不明原因复发性流产价值  

Value of Toll-like receptor 4 signaling pathway for predicting the occurrence of unexplained recurrent spontaneous abortion of women with polycystic ovary syndrome

作　　者：马萌 杜云辉 吴鹤立 MA Meng;DU Yunhui;WU Heli(Nanyang City Central Hospital,Henan Province,473000)

机构地区：[1]河南省南阳市中心医院,473000

出　　处：《中国计划生育学杂志》2023年第3期620-623,共4页Chinese Journal of Family Planning

摘　　要：目的:探究Toll样受体4(TLR4)信号通路预测多囊卵巢综合征(PCOS)合并不明原因复发性流产(URSA)价值。方法:收集2019年10月-2022年1月本院收治的92例PCOS合并URSA者为观察组,PCOS妊娠正常者50例为对照组,比较两组TLR4、核因子-kB(N F-kB)mRNA水平,多因素logistic回归模型分析PCOS合并URSA的影响因素,采用Spearman检验进行相关性分析,受试者工作特征曲线(ROC)评估TLR4、NF-kB mRNA水平预测PCOS合并URSA的效能。结果:与对照组比较,观察组体质指数(BMI)、饮酒、吸烟、胰岛素抵抗占比及TLR4、NF-kB mRNA水平明显增高(P<0.05)。logistic回归多因素分析显示,BMI、饮酒、吸烟、胰岛素抵抗及TLR4、NF-kB mRNA水平为PCOS合并URSA的影响因素(P<0.05)。相关性分析提示,TLR4、NF-kB mRNA水平与PCOS合并URSA均呈正性相关(r=0.474、0.511,均P<0.001)。ROC分析,TLR4、NF-kB mRNA联合应用时预测效能(AUC=0.792)高于各指标单独应用,其预测灵敏度、特异度分别为80.4%、74.0%,临界点为2.60、2.74。结论:TLR4信号通路与PCOS合并URSA关系密切,该通路相关分子TLR4、NF-kB mRNA水平为PCOS合并URSA的影响因素,对PCOS合并URSA有较好的预测效能。Objective:To explore the value of Toll-like receptor 4(TLR4)signaling pathway for predicting the occurrence of unexplained recurrent spontaneous abortion(URSA)of women with polycystic ovary syndrome(PCOS).Methods:92 women with PCOS complicating URSA were collected in study group and another 50 women with PCOS and normal pregnancy were collected in control group from October 2019 to January 2022.The mRNA expression levels of TLR4 and nuclear factor Kappa B(NF-κB)of the women were compared between two groups.Multivariate logistic regression model was used to analyze the factors affecting the occurrence of PCOS and URSA of the women.Spearman's correlation test was used to the correlative analysis.Receiver operating characteristic(ROC)curve was used to evaluate the efficacy of the TLR4 and NF-κB mRNA levels of the women for predicting their PCOS and URSA.Results:The body mass index(BMI)value,and the rates of alcohol consumption,smoking,and insulin resistance,and the mRNA levels of TLR4 and NF-kB of the women in the study group were significantly higher than those of the women in the control group(P<0.05).Multivariate logistic regression analysis showed that BMI,drinking,smoking,insulin resistance,and the TLR4 and NF-kB mRNA levels of the women were all the influencing factors of their PCOS complicating URSA(P<0.05).Correlation analysis indicated that the mRNA levels of TLR4 and NF-κB of the women were positively correlated with their PCOS and URSA oceurrence(r=0.474,0.511,all P<0.001).ROC analysis showed that the predictive efficacy(AUC=0.792)of the combined levels of TLR4 and NF-κB mRNA of the women for their PCOS and URSA occurrence was significantly higher than that of the TLR4 mRNA level or NF-κB mRNA level alone,and the sensitivity,the specificity,and the critical value of which were 80.4%,74.0%,and 2.6,respectively.Conclusion:TLR4 signaling pathway of the women with URSA is closely related to their occurrence of P-COs,the molecules TLR4 and NF-kB related with this pathway are the influencing factors of PCO

关 键 词：多囊卵巢综合征 不明原因复发性流产 TOLL样受体4 核因子-KB 影响因素 预测价值 

分 类 号：R711.75[医药卫生—妇产科学] R714.21[医药卫生—临床医学]