血清HLA-G、PLGF、IL-35对夫精宫腔内人工授精妊娠结局的预测价值  

Predictive value of serum HLA-G,PLGF,and IL-35 for pregnancy outcomes of intrauterine insemination with husband’s sperm

作　　者：欧阳杰 凡永 刘萍 OU Yang-Jie;FAN Yong;LIU Ping(Department of Reproductive Medicine,Hainan Western Central Hospital,Danzhou 571700;Department of Assisted Reproduction,the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200000)

机构地区：[1]海南西部中心医院生殖医学科,儋州571700 [2]上海交通大学附属第九人民医院辅助生殖科,上海200000

出　　处：《生殖医学杂志》2025年第2期164-170,共7页Journal of Reproductive Medicine

基　　金：儋州市科技和工业信息发展局科研项目(儋科工信(2024)81号)。

摘　　要：目的分析血清人类白细胞抗原-G(HLA-G)、胎盘生长因子(PLGF)、白介素-35(IL-35)水平对夫精宫腔内人工授精(IUI)患者妊娠结局的预测价值。方法回顾性分析2021年3月至2023年10月在海南西部中心医院行IUI患者的临床资料,共358个周期。根据妊娠结局分为妊娠组(n=62)和未妊娠组(n=296)。采用ELISA法检测患者血清HLA-G、PLGF、IL-35水平,比较各组间的一般资料、各血清因子水平;采用多因素Logistic回归分析IUI患者妊娠结局的影响因素,绘制受试者工作特征(ROC)曲线分析HLA-G、PLGF、IL-35水平对IUI患者妊娠结局的预测价值,采用Spearman及Pearson法分析HLA-G、PLGF、IL-35水平与年龄、卵巢功能指标的相关性。结果与妊娠组相比,未妊娠组的年龄、不孕年限显著升高(P<0.05),HCG日优势卵泡数>1的比例、抗苗勒管激素(AMH)水平显著降低(P<0.05),血清HLA-G、PLGF、IL-35水平显著降低(P<0.05)。Logistic回归分析显示,年龄[OR=1.405,95%CI(1.031,1.915),P=0.031]是患者妊娠结局的危险因素,血清HLA-G[OR=0.785,95%CI(0.618,0.997),P=0.047]、PLGF[OR=0.733,95%CI(0.559,0.961),P=0.024]、IL-35[OR=0.786,95%CI(0.624,0.991),P=0.041]均为妊娠结局的保护因素。ROC曲线分析表明,HLA-G、PLGF、IL-35水平、年龄以及联合预测患者妊娠结局的曲线下面积(AUC)分别为0.819、0.819、0.773、0.645、0.938,联合预测的灵敏度为83.11%,特异度为96.77%,联合预测显著优于HLA-G(Z=3.912,P=0.001)、PLGF(Z=4.111,P<0.001)、IL-35(Z=4.831,P<0.001)水平及年龄(Z=7.116,P<0.001)单独预测。相关性分析结果显示,HLA-G、IL-35水平与AMH水平呈正相关(P<0.05),PLGF水平与年龄呈负相关(P<0.05)、与AMH水平呈正相关(P<0.05)。结论经夫精IUI后未妊娠患者血清HLA-G、PLGF、IL-35水平降低,三者与年龄联合分析对妊娠结局具有一定辅助预测价值。Objective:To explore the predictive value of serum human leukocyte antigen-G(HLA-G),placental growth factor(PLGF),and interleukin-35(IL-35)levels in pregnancy outcomes of patients undergoing intrauterine insemination(IUI)with husband’s sperm.Methods:A retrospective analysis of clinical data of patients who underwent IUI with a total of 358 cycles at Hainan Western Central Hospital from March 2021 to October 2023 was conducted.The patients were assigned into the pregnancy group(n=62)and non-pregnancy group(n=296)based on pregnancy outcomes.The enzyme-linked immunosorbent assay(ELISA)was applied to detect serum HLA-G,PLGF,and IL-35 levels.The basic characteristics and the levels of serum parameters were compared between the two groups.Multivariate logistic regression was applied to analyze the influencing factors of pregnancy outcomes in IUI patients.Receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of HLA-G,PLGF,and IL-35 levels for pregnancy outcomes in IUI patients.Spearman and Pearson measures were used to analyze the correlation of HLA-G,PLGF,IL-35 levels with age and ovarian function indexes.Results:Compared with the pregnant group,the age and duration of infertility in the non-pregnancy group were significantly increased(P<0.05),the proportion of dominant follicles>1 on HCG day and the level of AMH were significantly reduced(P<0.05),and the levels of serum HLA-G,PLGF,and IL-35 were significantly reduced(P<0.05).Logistic regression analysis showed that age[OR=1.405,95%CI(1.031,1.915),P=0.031]was a risk factor for pregnancy outcomes,while serum HLA-G[OR=0.785,95%CI(0.618,0.997),P=0.047],PLGF[OR=0.733,95%CI(0.559,0.961),P=0.024],IL-35[OR=0.786,95%CI(0.624,0.991),P=0.041]were all protective factors for pregnancy outcomes.ROC curve analysis shows that,the area under the curve(AUC)of HLA-G,PLGF,IL-35,age and their combination for predicting pregnancy outcomes were 0.819,0.819,0.773,0.645,and 0.938,respectively.The sensitivity of combined prediction was 83.11%,and the specifi

关 键 词：夫精宫腔内人工授精 人类白细胞抗原-G 胎盘生长因子 白介素-35 妊娠结局 预测价值 

分 类 号：R711.6[医药卫生—妇产科学]