妊娠合并ADS患者血清SHBG、FABP4水平对妊娠结局的预测价值  

The Predictive Value of Serum SHBG and FABP4 Levels in Pregnant Women with ADS on Pregnancy Outcome

作　　者：王思思[1] 陈江平[1] 李琴琴[1] 于雪娟[1] 李芳[1] 马春星 WANG Sisi;CHEN Jiangping;LI Qinqin;YU Xuejuan;LI Fang;MA Chunxing(The Department of Gynecology,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院妇产科,河北张家口075000

出　　处：《标记免疫分析与临床》2023年第2期245-251,共7页Labeled Immunoassays and Clinical Medicine

基　　金：河北省医学科学重点课题(编号:20180851)。

摘　　要：目的 探讨妊娠合并子宫腺肌病(ADS)患者血清性激素结合球蛋白(SHBG)、脂肪酸结合蛋白4(FABP4)水平对妊娠结局的预测价值。方法 选取2019年11月至2021年10月我院妊娠合并ADS患者126例,另选取同期健康妊娠者63例为对照。比较妊娠合并ADS患者与健康妊娠者血清SHBG、FABP4水平。统计妊娠合并ADS患者与健康妊娠者的妊娠结局。分析妊娠合并ADS患者妊娠结局的影响因素,采用受试者工作特征曲线(ROC)评估血清SHBG、FABP4水平预测妊娠合并ADS患者妊娠结局的价值。绘制血清SHBG、FABP4水平评估妊娠合并ADS患者妊娠结局的决策曲线以分析其获益情况。结果 妊娠合并ADS患者血清SHBG水平低于健康妊娠者,FABP4水平高于健康妊娠者(P<0.05);126例妊娠合并ADS患者中,失访1例,不良妊娠结局42例,良好妊娠结局83例;妊娠合并ADS患者早产率、流产率高于健康妊娠者(P<0.05);年龄>35岁、妊娠期高血压、妊娠期糖尿病、雌激素受体阳性、孕激素受体阳性、体外授精胚胎移植、CA125>35U/mL、FABP4水平高是妊娠合并ADS患者不良妊娠结局的独立危险因素,SHBG水平高是不良妊娠结局的保护因素(P<0.05);ROC分析显示SHBG联合FABP4评估妊娠合并ADS患者妊娠结局的AUC值高于SHBG、FABP4单独检测;决策曲线分析显示在阈值0.10~0.84范围内,SHBG联合FABP4评估妊娠合并ADS患者妊娠结局的价值高于SHBG、FABP4单独检测。结论 妊娠合并ADS患者血清SHBG、FABP4水平均异常表达,其中血清SHBG低表达、FABP4高表达表明患者存在较高不良妊娠结局风险,二者可作为评估妊娠合并ADS患者妊娠结局的辅助指标。Objective To analyze levels of serum sex hormone tuberculosis globulin(SHBG)and Fatty acid-binding protein 4(FABP4)in pregnant patients with adenomyosis and evaluate their predictive values for pregnancy outcome.Methods A total of 126 pregnant patients with adenomyosis in our hospital from November,2019 to October,2021 were selected for the study,while 63 healthy pregnant women during the same period were selected as controls.Serum SHBG and FABP4 levels were compared between pregnant women with adenomyosis and healthy pregnant women.The pregnancy outcomes of pregnant women with adenomyosis and healthy pregnancy were analyzed.The influencing factors of pregnancy outcome in patients with pregnancy complicated with adenomyosis were analyzed,and the receiver operating characteristic curve(ROC)was drawn to evaluate the value of serum SHBG and FABP4 levels in predicting pregnancy outcome in pregnant women with adenomyosis.The decision curve of serum SHBG and FABP4 levels to evaluate the pregnancy outcome of pregnant patients with adenomyosis was used to analyze their potential benefits.Results Serum SHBG level of pregnant patients with adenomyosis was lower than that of healthy pregnancy,while FABP4 level was higher than that of healthy pregnancy(P<0.05).Among 126 pregnant patients with adenomyosis,1 was lost to follow-up,42 had adverse pregnancy outcomes,and 83 had good pregnancy outcomes.The preterm birth rate and miscarriage rate of pregnancy complicated with adenomyosis were higher than those of healthy pregnancy(P<0.05).Age>35 years,gestational hypertension,gestational diabetes mellitus,estrogen receptor positive,progesterone receptor positive,in vitro fertilization embryo transfer,cancer antigen(cancer antigen)125>35U/mL,high FABP4 level were pregnancy complications independent risk factors for adverse pregnancy outcomes in patients with adenomyosis,while high SHBG level was a protective factor for adverse pregnancy outcomes(P<0.05).ROC analysis showed that the AUC value of SHBG combined with FABP4 in evaluating

关 键 词：子宫腺肌病 妊娠 性激素结合球蛋白 脂肪酸结合蛋白4 妊娠结局 

分 类 号：R711.74[医药卫生—妇产科学]