先兆流产保胎治疗孕妇血清PCSK9和CTRP6水平对妊娠结局的预测价值研究  

Predictive Value of Serum PCSK9 and CTRP6 in Pregnant Women Undergoing Threatened Abortion and Fetal Protection Treatment on Pregnancy Outcomes

作　　者：段宁娟 刘燕[3] 王振威 DUAN Ningjuan;LIU Yan;WANG Zhenwei(Department of Obstetrics,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712000,China;Department of Gynaecology,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712000,China;Department of Gynaecology,the First Affiliated Hospital of Xi’an Medical University,Xi’an 710077,China)

机构地区：[1]陕西中医药大学第二附属医院产科,陕西咸阳712000 [2]陕西中医药大学第二附属医院妇科,陕西咸阳712000 [3]西安医学院第一附属医院妇科,西安710077

出　　处：《现代检验医学杂志》2024年第1期106-111,共6页Journal of Modern Laboratory Medicine

基　　金：陕西省卫生健康科研基金项目(编号:2018D085):陕西咸阳地区妊娠期甲减的流行病学研究。

摘　　要：目的探究先兆流产保胎治疗孕妇血清前蛋白转化酶枯草溶菌素9(proprotein convertase subtilisin/kexin type 9,PCSK9),C1q肿瘤坏死因子相关蛋白6(complement-C1q/tumor necrosis factor-related protein 6,CTRP6)水平对妊娠结局的预测价值。方法选取2021年08月~2022年05月在陕西中医药大学第二附属医院行保胎治疗的80例先兆流产孕妇为研究对象,根据妊娠结局将其分为良好妊娠结局组(n=62)、不良妊娠结局组(n=18);另选取同期在该院孕检正常的孕妇60例作为对照组。采用酶联免疫吸附法(ELISA)检测研究对象血清PCSK9,CTRP6,孕酮和β-人绒毛膜促性腺激素(β-HCG)水平;采用Pearson法分析血清PCSK9,CTRP6水平与孕酮,β-HCG水平的相关性;采用多因素Logistic回归分析影响先兆流产保胎治疗孕妇妊娠结局的因素;采用受试者工作特征(ROC)曲线分析先兆流产保胎治疗孕妇血清PCSK9和CTRP6对妊娠结局的预测价值。结果对照组、良好妊娠结局组和不良妊娠结局组的孕酮(45.65±3.48,38.29±3.54和31.56±4.11 nmol/L),β-HCG(32056.56±4244.54,23642.32±3897.67和11375.56±3454.35 mIU/L),CTRP6(436.53±36.23,328.44±31.06和277.86±25.56 ng/ml)水平均呈逐渐降低趋势,PCSK9(64.22±10.35,82.24±13.33和114.56±17.67 ng/ml)表达水平呈逐渐升高趋势,差异具有统计学意义(F=129.231,199.334,244.007,111.297,均P<0.05)。Pearson法分析显示,血清PCSK9与孕酮、β-HCG水平呈负相关(r=-0.545,-0.514,均P<0.05),血清CTRP6与孕酮、β-HCG水平呈正相关(r=0.567,0.496,均P<0.05)。多因素Logistic回归分析显示,PCSK9水平升高为先兆流产保胎治疗孕妇妊娠结局的独立危险因素,CTRP6,孕酮、β-HCG水平升高为先兆流产保胎治疗孕妇妊娠结局的独立保护因素(P<0.05)。ROC结果显示,先兆流产保胎治疗孕妇血清PCSK9,CTRP6预测患者发生不良妊娠结局的曲线下面积(AUC)分别为0.843,0.849,两者联合预测的AUC为0.941,优于两者各自单独预测(Z=1.725,1.882Objective To explore the predictive value of serum proprotein convertase subtilisin/kexin type 9(PCSK9)and proprotein convertase subtilisin/kexin type 9(CTRP6)in pregnant women undergoing threatened abortion and fetal protection treatment for pregnancy outcomes.Methods Eighty pregnant women with threatened abortion who were treated in the Second Affiliated Hospital of Shaanxi University of Chinese Medicine from August 2021 to May 2022 were selected as the study subjects.According to the pregnancy outcome,they were grouped into the good pregnancy outcome group(n=62)and the bad pregnancy outcome group(n=18),while another 60 pregnant women with normal pregnancy tests in the hospital were selected as the control group.The serum levels of PCSK9,CTRP6,progesterone andβ-human chorionic gonadotropin(β-HCG)were measured by enzyme-linked immunosorbent assay(ELISA).Pearson method was applied to analyze the correlation between serum PCSK9,CTRP6 levels and progesterone andβ-HCG levels.Multivariate Logistic regression analysis was applied to analyze the factors affecting the pregnancy outcomes of pregnant women with threatened abortion.The predictive value of serum PCSK9 and CTRP6 on pregnancy outcome of pregnant women with threatened abortion and pregnancy protection treatment was analyzed by the receiver operating characteristic(ROC)curve.Results The level of progesterone(45.65±3.48,38.29±3.54 and 31.56±4.11 nmol/L),β-HCG(32056.56±4244.54,23642.32±3897.67 and 11375.56±3454.35 mIU/L)and CTRP6(436.53±36.23,328.44±31.06 and 277.86±25.56 ng/ml)in control group,good pregnancy outcome group and bad pregnancy outcome group decreased gradually,while the level of PCSK9(64.22±10.35,82.24±13.33 and 114.56±17.67 ng/ml)in the control group,the good pregnancy outcome group and the bad pregnancy outcome group increased gradually,with statistically significant differences(F=129.231,199.334,244.007,111.297,all P<0.05).Pearson method showed that serum PCSK9 was negatively correlated with progesterone andβ-HCG levels(r=-0.545,

关 键 词：前蛋白转化酶枯草溶菌素9 C1q肿瘤坏死因子相关蛋白6 先兆流产 妊娠结局 

分 类 号：R714.21[医药卫生—妇产科学] R392.11[医药卫生—临床医学]