血清Netrin-1、Vitronectin诊断早期妊娠稽留流产价值  

Effects of the levels of axon guidance factor-1 and vitronectin on missed abortion during the first trimester of pregnancy and their evaluative value

作　　者：庄文珂[1] 何晓英 王蓓颖[1] ZHUANG Wenke;HE Xiaoying;WANG Beiying(Shanghai First Maternal and Infant Health Care Hospital,Shanghai,350011)

机构地区：[1]上海市第一妇婴保健院,350011

出　　处：《中国计划生育学杂志》2023年第10期2499-2502,2505,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨血清神经轴突导向因子-1(netrin-1)、玻连蛋白(Vitronectin)诊断早期妊娠稽留流产价值。方法:回顾性收集2018年1月-2021年12月本院收治的124例早期妊娠孕妇临床资料,并据妊娠结局分为早期流产60例(早期流产组)、稽留流产64例(稽留流产组),同期产前检查健康孕妇62例为对照组。入院后均采用酶联免疫吸附法检测血清Netrin-1、Vitronectin水平,Pearson相关分析二者关系,绘制受试者工作特征曲线(ROC)评估其对早期妊娠稽留流产发生价值;采用多因素logistic回归分析早期妊娠发生稽留流产的危险因素。结果:血清Netrin-1和Vitronectin水平,稽留流产组(48.63±9.63 pg/ml、32.25±6.24μg/ml),早期流产组(89.36±10.55 pg/ml、50.20±7.44μg/ml),对照组(156.41±12.44 pg/ml、75.63±8.63μg/ml)依次升高(P<0.05)。Pearson相关分析显示,稽留流产组血清Netrin-1与Vitronectin呈正相关(r=0.523,P<0.001)。ROC曲线分析,预诊断早期妊娠稽留流产,Netrin-1的曲线下面积0.769,截断值98.5pg/ml,敏感度92.2%、特异度51.7%;Vitronectin曲线下面积0.832,截断值53.6μg/ml,敏感度92.2%、特异度68.3%;Netrin-1联合Vitronectin曲线下面积0.810,敏感度87.5%、特异度85.5%。多因素logistic回归模型分析,血清Netrin-1降低、Vitronectin降低、流产史均为早期妊娠发生稽留流产的危险因素(P<0.05)。结论:早期妊娠发生稽留流产者血清Netrin-1、Vitronectin水平异常降低,且二者呈正相关性,是发生稽留流产的危险因素,对诊断稽留流产发生有一定价值。Objective:To explore the diagnostic value of the levels of serum axon guidance factor-1(netrin-1)and vitronectin of women during the first trimester of pregnancy for their missed abortion.Methods:The clinical data of 124 women with missed abortion during the first trimester of pregnancy from January 2018 to December 2021 were col-lected retrospectively.According to the pregnancy outcomes,these women were divided 60 patients with abortion ingroup A and 64 patients with missed abortion in group B.62 normal pregnant women who underwent physical exami-nation were selected in group C.The levels of serum netrin-1 and vitronectin of the women in the three groups were de-tected by enzyme-linked immunosorbent assay.Pearson correlation analysis was used toexplore the correlation betweenthe serum Netrin-1 level of the women and their serum vitronectin level.Receiver operating characteristic curve(ROC)was drawn to evaluate the diagnostic value of the levels of serum netrin-1 and vitronectin of the women for their missedabortion,Therisk factors of missed miscarriage of the pregnant women wereexplored by multi-factor logistic regression analysis.Results:The serum netrin-1 and vitronectin levels of the women in group B(48.63±9.63 pg/ml and32.25±6.24μg/ml),ingroupA(89.36±10.55pg/ml and 50.20±7.44μg/ml),andingroupC(156.41±12.44pg/mland 75.63±8.63μg/ml)had increased gradually(P<0.05).Pearson correlation analysis showed that the serum netrin-1 level of the women in group B was positively correlated with their vitronectin level(r=0.523,P<0.001).ROC curve analysis showed that the ara under the curve,the cutoff value the sensitivity,and the cificity of the netrin-1 level of the women for predicting theirmissed abortion during thefirst trimesterof pregnancy wefe 0.769,98.5pg/ml,92.2%,and 51.7%,respectively.The area under the curvethe cutoffvalue,the sensitivity,and the specificity of thevitronectin level of the women for predicting their missed abortion during the first trimester of pregnancy were 0.832,53.6μg/ml,92.2%and 68.

关 键 词：早期妊娠 稽留流产 玻连蛋白 神经轴突导向因子-1 相关性 危险因素 诊断价值 

分 类 号：R714.21[医药卫生—妇产科学]