孕中期肌酸激酶、血管内皮生长因子与瘢痕子宫孕妇发生胎盘植入性疾病的关系及对胎盘植入程度的预测研究  

Relationship between creatine kinase,vascular endothelial growth factor and placental accretion in pregnant women with cicatricial uterus and the prediction of placental accretion degree

作　　者：涂业秀 李燕燕 苏艳洁 唐哲文 邓新琼 TU Ye-xiu;LI Yan-yan;SU Yan-jie(Department of Obstetrics,Liuzhou Maternity and Child Healthcare Hospital,Liuzhou Guangxi 545001,China)

机构地区：[1]柳州市妇幼保健院产科,广西柳州545001 [2]广西妇产疾病临床医学研究中心,广西柳州545001

出　　处：《临床和实验医学杂志》2023年第15期1639-1642,共4页Journal of Clinical and Experimental Medicine

基　　金：广西壮族自治区科学技术厅科技计划项目(编号:桂科AD22035223);广西壮族自治区科学技术厅重点研发计划项目(编号:桂科AB18126056)。

摘　　要：目的探讨孕中期肌酸激酶(CK)、血管内皮生长因子(VEGF)与瘢痕子宫孕妇发生胎盘植入性疾病的关系及对胎盘植入程度的预测价值。方法回顾性选取2019年7月至2022年7月柳州市妇幼保健院收治的70例瘢痕子宫伴胎盘植入性疾病孕妇作为观察组,其中粘连型52例,植入型或穿透型18例;另选70例瘢痕子宫不伴胎盘植入性疾病孕妇作为对照组。比较两组孕中期CK、VEGF表达水平;采用多因素Logistic回归分析分析瘢痕子宫孕妇发生胎盘植入性疾病的独立预测因素;采用受试者工作特征(ROC)曲线分析孕中期CK联合VEGF对瘢痕子宫孕妇发生胎盘植入性疾病的预测效能;分析孕中期CK、VEGF在不同胎盘植入程度孕妇中的差异性;采用Pearson相关性分析分析孕中期CK、VEGF与胎盘植入超声评分量表评分的关系。结果观察组孕中期CK、VEGF水平分别为(138.42±25.69)U/L、(198.42±46.13)pg/mL,均高于对照组[(72.32±10.48)U/L、(121.23±23.47)pg/mL],差异均有统计学意义(P<0.05)。经多因素Logistic回归分析,孕中期CK、VEGF均是瘢痕子宫孕妇发生胎盘植入性疾病的独立预测因素(OR=2.562,95.0%CI:1.441~6.059;OR=0.356,95.0%CI:0.128~0.832;P<0.05)。经ROC曲线分析,孕中期CK联合VEGF预测瘢痕子宫孕妇发生胎盘植入性疾病的曲线下面积(AUC)为0.903。在观察组70例瘢痕子宫伴胎盘植入性疾病孕妇中,植入型或穿透型孕妇孕中期CK、VEGF水平分别为(157.84±36.72)U/L、(253.16±58.74)pg/mL,均高于粘连型[(112.43±18.74)U/L、(154.75±35.81)pg/mL],差异均有统计学意义(P<0.05)。经Pearson相关性分析,瘢痕子宫伴胎盘植入性疾病孕妇孕中期CK、VEGF水平与胎盘植入超声评分量表评分均呈正相关(P<0.05)。结论孕中期CK联合VEGF预测瘢痕子宫孕妇发生胎盘植入性疾病的效能较好,有助于评估胎盘植入程度。Objective To investigate the relationship between creatine kinase(CK),vascular endothelial growth factor(VEGF)and placental accretion in pregnant women with cicatricial uterus and the predictive value of placental accretion degree.Methods From July 2019 to July 2022,70 pregnant women with cicatricial uterus and placenta accreta admitted to Liuzhou Maternal and Child Health Hospital were retrospectively selected as the observation group,52 cases of adhesive type,18 cases of implanted or penetrating type;and another 70 pregnant women with cicatricial uterus without placenta accreta were selected as the control group.The expression levels of CK and VEGF in the second trimester were compared between the two groups.Multivariate Logistic regression was used to analyze the independent predictors of placental accreta in pregnant women with scar uterus.The predictive efficacy of CK combined with VEGF in the prediction of placental accreta in pregnant women with scar uterus was analyzed by receiver operating characteristic(ROC)curve.The differences of CK and VEGF in pregnant women with different placental implantation degrees in the second trimester were analyzed,and Pearson correlation was used to analyze the relationship between CK,VEGF and placental implantation ultrasound score scale in the second trimester.Results The levels of CK and VEGF in the observation group during the second trimester were(138.42±25.69)U/L,(198.42±46.13)pg/mL,respectively,which were higher than those in the control group[(72.32±10.48)U/L,(121.23±23.47)pg/mL],the differences were statistically significant(P<0.05).Multiple Logistic regression analysis showed that CK and VEGF in the second trimester were independent predictors of placental accretion disease in pregnant women with cicatricial uterus(OR=2.562,95.0%CI:1.441-6.059;OR=0.356,95.0%CI:0.128-0.832;P<0.05).According to ROC curve analysis,the area under the curve(AUC)of CK combined with VEGF in predicting placental accreta disease in pregnant women with scar uterus was 0.903.In the obser

关 键 词：胎盘疾病 肌酸激酶 血管内皮生长因子类 瘢痕子宫 胎盘植入程度 

分 类 号：R714.2[医药卫生—妇产科学]