血清NLRP3和IL-1β水平与IVF-ET反复种植失败的关系及预测价值  

Relationship and predictive value of serum NLRP3and IL-1βlevels with repeated implantation failure of IVF-ET

作　　者：杜营 DU Ying(Department of General Practice Beijing Daxing District People’s Hospital,Beijing102600,China)

机构地区：[1]北京市大兴区人民医院全科医学科,北京102600

出　　处：《中国实验诊断学》2025年第1期35-40,共6页Chinese Journal of Laboratory Diagnosis

基　　金：北京市科技计划项目(Z211200004010090)。

摘　　要：目的探讨血清核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、白细胞介素-1β(IL-1β)水平与体外受精-胚胎移植(IVF-ET)反复种植失败(RIF)的关系及预测价值。方法选取2022年6月~2024年3月在北京市大兴区人民医院行IVF-ET的患者205例。将出现RIF的27例纳入观察组,其余178例纳入对照组。均在取卵前、胚胎移植前测定血清NLRP3和IL-1β水平。分析NLRP3,IL-1β与RIF的关系及预测价值。建立限制性立方样条模型拟合血清NLRP3,IL-1β水平与RIF的剂量-效应关系。结果205例IVF-ET患者RIF发生率为13.17%(27/205),观察组患者继发性不孕和宫腔镜检查异常比率大于对照组,基础AMH小于对照组(P<0.05)。2组患者胚胎移植前血清NLRP3和IL-1β水平高于取卵前,但观察组低于对照组(P<0.05)。宫腔镜检查异常是RIF的独立危险因素,AMH、NLRP3和IL-1β是RIF的独立保护因素(P<0.05)。胚胎移植前患者血清NLRP3和IL-1β水平预测RIF的AUC值分别为0.748和0.785,两指标联合预测RIF的AUC值为0.868,高于血清NLRP3(Z=2.866,P=0.004)、IL-1β(Z=2.297,P=0.022)水平单独预测。当血清NLRP3水平<785pg/ml,血清IL-1β水平<85pg/ml时,RIF的风险随血清NLRP3,IL-1β水平降低而增加。结论血清NLRP3和IL-1β是RIF的独立保护因素,通过检测二者水平可预测RIF发生风险。Objective To investigate the relationship and predictive value of serum nucleotide-binding oligomeric domain interleukin-1β(IL-1β)levels with repeated implantation failure(RIF)in vitro fertilization-embryo transfer(IVFET).Methods A total of 205patients who underwent IVF-ET in our hospital from June 2022to March 2024were selected.Twenty-seven patients with RIF were included in the observation group and the other 178were included in the control group.Serum NLRP3and IL-1βlevels were measured before egg retrieval and embryo transfer.The relationship and predictive value of NLRP3,IL-1βand RIF were analyzed.A restricted cubic spline model was established to fit the dose-response relationship between serum NLRP3,IL-1βlevels and RIF.Results The incidence of RIF in 205patients with IVF-ET was 13.17%(27/205).The incidence of secondary infertility and abnormal hysteroscopy in the observation group was higher than that in the control group,and the basal AMH was lower than that in the control group(P<0.05).The levels of serum NLRP3and IL-1βbefore embryo transfer were higher in both groups than before egg retrieval,but lower in observation group than in control group(P<0.05).Abnormal hysteroscopy was an independent risk factor for RIF,and AMH,NLRP3,IL-1βwere independent protective factors for RIF(P<0.05).The AUC value of serum NLRP3and IL-1βbefore embryo transfer was 0.748and 0.785,respectively,and the AUC value of RIF predicted by the two indexes combined was 0.868,which was higher than that of serum NLRP3(Zstatistic=2.866,P=0.004)and IL-1β(Zstatistic=2.297,P=0.022)level forecast alone respectively.When the serum NLRP3level is<785pg/ml and the serum IL-1βlevel is<85pg/ml,the risk of RIF increases with the decrease of the serum NLRP3,IL-1βlevel.Conclusion Serum NLRP3and IL-1βare independent protective factors for RIF,and detection of their levels can predict the risk of RIF.

关 键 词：核苷酸结合寡聚化结构域祥受体蛋白3 白细胞介素-1Β 体外受精-胚胎移植 反复种植失败 

分 类 号：R714.8[医药卫生—妇产科学] R446.11[医药卫生—临床医学]