不明原因复发性流产再次妊娠早孕期患者MCV、HCG、IFN-γ/IL-10比值与妊娠结局的关系研究  

Relationship Study between MCV,HCG,IFN-γ/IL-10 Ratio and Pregnancy Outcome in the Second Trimester Early Pregnancy Patients with Unexplain Recurrent Spontaneous Abortion

作　　者：潘惠娟 张春芳 杨凤娜 魏志玲 王芳[1,2] PAN Hui-juan;ZHANG Chun-fang;YANG Feng-na;WEI Zhi-ling;WANG Fang(The Second Clinical Medical College of Lanzhou University,Lanzhou,Gansu,730030,China;Department of Reproductive Medicine,The Second Hospital of Lanzhou University,Lanzhou,Gansu,730030,China)

机构地区：[1]兰州大学第二临床医学院,甘肃兰州730030 [2]兰州大学第二医院生殖医学科,甘肃兰州730030

出　　处：《现代生物医学进展》2023年第5期898-903,共6页Progress in Modern Biomedicine

基　　金：甘肃省科技支撑计划项目(14SRJ2A160)。

摘　　要：目的:探讨不明原因复发性流产(URSA)再次妊娠早孕期患者平均红细胞体积(MCV)、人绒毛膜促性腺激素(HCG)、γ-干扰素(IFN-γ)/白介素-10(IL-10)比值与妊娠结局的关系。方法:选择2019年9月~2021年5月期间兰州大学第二医院生殖医学科收治的105例URSA再次妊娠早孕期患者作为研究组,将研究组根据妊娠结局分为妊娠成功组(成功分娩,n=71)和妊娠失败组(再次流产,n=34)。选取同期来兰州大学第二医院生殖医学科产检健康的80例孕妇作为对照组。对比研究组、对照组的MCV、HCG、IFN-γ/IL-10比值,多因素Logistic回归分析妊娠结局的影响因素,采用受试者工作特征(ROC)曲线评估MCV、HCG、IFN-γ/IL-10比值单独及联合检测URSA再次妊娠早孕期患者妊娠结局的预测效能。结果:研究组的MCV、IFN-γ/IL-10比值大于对照组,HCG小于对照组(P<0.05)。URSA再次妊娠早孕期患者妊娠结局与年龄、就诊时孕周、胰岛素抵抗指数(HOMA-IR)、孕早期宫腔积液、孕前调理、内分泌异常、抗精子抗体(ASA)阳性、抗心磷脂抗体(ACA)阳性、宫颈机能不全、MCV、HCG、IFN-γ/IL-10比值有关(P<0.05)。多因素Logistic回归分析显示,年龄偏大、就诊时孕周较长、高MCV、低HCG、高IFN-γ/IL-10比值和URSA再次妊娠早孕期患者妊娠不良结局密切关联(P<0.05)。MCV、HCG、IFN-γ/IL-10比值联合检测对URSA再次妊娠早孕期患者妊娠结局预测的效能较高。结论:MCV、HCG、IFN-γ/IL-10比值在URSA再次妊娠早孕期患者妊娠结局具有一定的预测价值,且联合检测效果更好。此外,年龄偏大、就诊时孕周较长、高MCV、低HCG、高IFN-γ/IL-10比值为URSA再次妊娠早孕期患者妊娠结局的独立危险因素。Objective:To investigate the relationship between mean corpuscular volume(MCV),human chorionic gonadotropin(HCG),interferon-(IFN-)/interleukin-10(IL-10)ratio and pregnancy outcome in the second trimester early pregnancy patients with unexplain recurrent spontaneous abortion(URSA).Methods:105 second trimester early pregnancy patients with URSA who were admitted to Department of Reproductive Medicine,The Second Hospital of Lanzhou University from September 2019 to May 2021 were selected as the study group.According to the pregnancy outcome,the study group was divided into pregnancy successful group(successful delivery,n=71)and pregnancy failure group(repeat abortion,n=34).80 healthy pregnant women who came to our hospital for prenatal examination in the same period were selected as the control group.The MCV,HCG,IFN-/IL-10 ratio in the study group and the control group were compared,and the influencing factors of pregnancy outcome in the second trimester early pregnancy patients with URSA were analyzed by multivariate Logistic regression.The receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of MCV,HCG and IFN-γ/IL-10 ratio in the second trimester early pregnancy patients with URSA alone and in combination.Results:The MCV and IFN-γ/IL-10 ratio in the study group were higher than those in the control group,and HCG was lower than that in the control group(P<0.05).Pregnancy outcomes in the second trimester early pregnancy patients with URSA were related to age,gestational age at visit,insulin resistance index(HOMA-IR),uterine effusion in the first trimester,prepregnancy conditioning,endocrine abnormalities,positive anti-sperm antibody(ASA),positive anti-cardiolipin antibody(ACA),cervical insufficiency,MCV,HCG,IFN-γ/IL-10 ratio(P<0.05).Multivariate Logistic regression analysis showed that older age,longer gestational age at visit,high MCV,low HCG,and high IFN-γ/IL-10 ratio were closely related to the adverse pregnancy outcome in the early pregnancy patients with URSA(P<0.05).The

关 键 词：复发性流产 妊娠早孕期 MCV HCG IFN-γ/IL-10 妊娠结局 

分 类 号：R714.21[医药卫生—妇产科学]