α_(1)抗胰蛋白酶、D-二聚体及同型半胱氨酸联合检测对先兆流产患者妊娠结局的预测效能  

Predictive efficacy of combined detection of α_(1) antitrypsin,D-dimer and homocysteine on pregnancy outcome in patients with threatened abortion

作　　者：陈波[1] CHEN Bo(Department of Laboratory,Pingxiang People's Hospital,Jiangxi Province,Pingxiang 337000,China)

机构地区：[1]江西省萍乡市人民医院检验科,江西萍乡337000

出　　处：《中国当代医药》2024年第15期14-17,23,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202212196)。

摘　　要：目的探讨α_(1)抗胰蛋白酶(AAT)、D-二聚体(D-D)及同型半胱氨酸(Hcy)联合检测对先兆流产患者妊娠结局的预测效能。方法回顾性分析2021年6月至2023年1月江西省萍乡市人民医院收治的100例先兆流产接受保胎治疗患者的临床资料,依据妊娠结局划分为保胎失败组、保胎成功组。比较两组基线资料、孕早期血清AAT、D-D及Hcy水平;采用logistic回归分析探究血清AAT、D-D及Hcy水平与先兆流产患者妊娠结局的关系;采用受试者工作特征(ROC)曲线分析血清AAT、D-D及Hcy水平对先兆流产患者妊娠结局的预测效能。结果100例先兆流产患者经保胎治疗后难免流产20例(20.00%)、过期流产15例(15.00%),纳入保胎失败组;继续妊娠至顺利分娩65例(65.00%),纳入保胎成功组。保胎失败组患者在保胎治疗前的血清AAT水平低于保胎成功组,D-D及Hcy水平均高于保胎成功组,差异有统计学意义(P<0.05);logistic回归分析显示,更高的血清AAT(β=-1.769,OR=0.170,95%CI=0.068~0.429)为先兆流产患者妊娠结局的独立保护因素,更高的D-D(β=2.504,OR=12.229,95%CI=4.037~37.045)、Hcy(β=0.612,OR=1.844,95%CI=1.212~2.804)均为先兆流产患者妊娠结局的独立危险因素(P<0.05);绘制ROC曲线显示,血清AAT、D-D及Hcy水平均可用于预测先兆流产患者妊娠结局,三者联合预测时预测效能最高,AUC为0.898,敏感度、特异度分别为88.57%、78.46%。结论血清AAT、D-D及Hcy水平均与先兆流产患者妊娠结局有关,临床若出现AAT低表达、D-D及Hcy高表达,应警惕先兆流产发生。Objective To investigate the predictive efficacy of combined detection of α_(1)-antitrypsin(AAT),D-dimer(D-D)and homocysteine(Hcy)on pregnancy outcome in patients with threatened abortion.Methods The clinical data of 100 patients with threatened abortion who received tocolysis treatment in Pingxiang People's Hospital from June 2021 to January 2023 were retrospectively analyzed.According to the pregnancy outcome,they were divided into tocolysis failure group and tocolysis success group.The baseline data,serum AAT,D-D and Hcy levels in early pregnancy were compared between the two groups.Logistic regression analysis was used to explore the relationship between serum AAT,D-D and Hcy levels and pregnancy outcome in patients with threatened abortion.The ROC curve was used to analyze the predictive efficacy of serum AAT,D-D and Hcy levels on pregnancy outcome in patients with threatened abortion.Results Among the 100 patients with threatened abortion,20 cases(20.00%)had inevitable abortion and 15 cases(15.00%)had delayed abortion after tocolytic therapy,which were included in the tocolysis failure group,65 cases(65.00%)continued pregnancy to successful delivery and were included in the tocolysis success group.The level of serum AAT in the tocolysis failure group was lower than that in the tocolysis success group before the treatment,and the levels of D-D and Hcy were higher than those in the tocolysis success group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that higher serum AAT(β=-1.769,OR=0.170,95%CI=0.068-0.429)was a independent protective factor for pregnancy outcome in patients with threatened abortion,and higher D-D(β=2.504,OR=12.229,95%CI=4.037-37.045)and Hcy(β=0.612,OR=1.844,95%CI=1.212-2.804)were independent risk factors for pregnancy outcome in patients with threatened abortion(P<0.05).The ROC curve showed that serum AAT,D-D and Hcy levels could be used to predict the pregnancy outcome of patients with threatened abortion.The combined prediction of the t

关 键 词：先兆流产 妊娠结局 α_(1)抗胰蛋白酶 D-二聚体 同型半胱氨酸 

分 类 号：R714.21[医药卫生—妇产科学]