血清fFN、MCP-1、IL-6与妊娠糖尿病自发性早产的关系及其预测价值  

Correlation of Serum fFN,MCP-1 and IL-6 with Spontaneous Preterm Birth in Gestational Diabetes Mellitus and Their Predictive Value

作　　者：李江丽 关娜[1] LI Jiangli;GUAN Na(Obstetrics Department,the First People’s Hospital of Pingdingshan City,Pingdingshan 467000,China)

机构地区：[1]平顶山市第一人民医院产科,河南平顶山467000

出　　处：《河南医学研究》2025年第3期486-489,共4页Henan Medical Research

摘　　要：目的探究血清胎儿纤维连接蛋白(fFN)、单核细胞趋化蛋白-1(MCP-1)、白介素-6(IL-6)与妊娠糖尿病自发性早产的关系及预测价值。方法回顾性选取2021年5月至2022年12月选取平顶山市第一人民医院就诊的120例妊娠糖尿病患者为研究对象,根据其是否自发性的早产分为早产组(51例)和非早产组(69例),收集患者的一般资料[年龄、孕前体重指数(BMI)、月经初潮年龄、妊娠期感染史、孕次、流产史、剖宫产史、贫血、血压等信息],采集患者的清晨空腹外周血,通过酶联免疫吸附法检测血清fFN、MCP-1、IL-6水平,采用多因素logistic回归分析妊娠糖尿病发生自发性早产的危险因素,并采用受试者工作特征(ROC)曲线分析妊娠糖尿疾病者血清fFN、MCP-1、IL-6水平对发生自发性早产的预测价值。结果两组患者的年龄、孕前BMI、血压、月经初潮年龄、孕次、流产史、剖宫产史、贫血情况差异无统计学意义(P>0.05),两组患者的妊娠期感染史差异有统计学意义(P<0.05)。早产组的血清fFN、MCP-1、IL-6水平均高于非早产组(P<0.05)。多因素logistic回归结果显示,妊娠期感染史和血清fFN、MCP-1、IL-6是妊娠糖尿病发生自发性早产的危险因素(P<0.05),有妊娠期感染的患者和血清fFN、MCP-1、IL-6水平越高的患者,其发生自发性早产的风险越大。由ROC曲线分析可得,血清fFN、MCP-1、IL-6水平预测妊娠糖尿病发生自发性流产的AUC分别为0.798、0.685、0.746,灵敏度分别为74.5%、58.8%、62.7%,特异度分别为76.8%、84.1%、85.5%;3个指标联合预测的AUC为0.889,灵敏度为86.3%,特异度为91.3%。结论妊娠糖尿病自发性早产产妇的血清fFN、MCP-1、IL-6水平均升高,妊娠期感染和高水平的血清fFN、MCP-1、IL-6是妊娠糖尿病发生自发性早产的危险因素。血清fFN、MCP-1、IL-6对妊娠糖尿病发生自发性早产具有较高的预测价值,且联合预测的效能更高。Objective To explore the correlation of serum fetal fibronectin(fFN),monocyte chemotactic protein-1(MCP-1),interleukin-6(IL-6)with spontaneous preterm birth in gestational diabetes mellitus and their predictive value.Methods Retrospective selection of 120 patients with gestational diabetes from May 2021 to December 2022 in the First People’s Hospital of Pingdingshan City,and classified into two groups according to the presence or absence of spontaneous preterm birth,preterm group(51 cases)and term group(69 cases).General data including age,pre-pregnancy body mass index(BMI),age at menarche,history of infection during pregnancy,number of pregnancies,history of miscarriage,history of cesarean delivery,anemia,blood pressure were recorded.The early morning fasting peripheral venous blood samples were collocated,and serum fFN,MCP-1 and IL-6 levels were measured using enzyme-linked immunosorbent assay(ELISA).Multivariate logistic regression was utilized to screen the risk factors of spontaneous preterm birth in gestational diabetes mellitus,and receiver operating characteristic(ROC)curve was plotted to evaluate predictive value of serum fFN,MCP-1 and IL-6 levels in spontaneous preterm birth in gestational diabetes mellitus patients.Results Age,pre-pregnancy BMI,blood pressure,age at menarche,number of pregnancies,miscarriage and cesarean delivery,and anemia yielded no statistical difference between two groups(P>0.05),while statistical difference was found in the history of infection during pregnancy(P<0.05).Serum fFN,MCP-1 and IL-6 levels were notably higher in preterm group than in term group(P<0.05).Multivariate logistic regression analysis revealed that history of infection during pregnancy,serum fFN,MCP-1 and IL-6 were all risk factors for spontaneous preterm birth in gestational diabetes mellitus(P<0.05).Patients with history of infection during pregnancy,and elevated serum fFN,MCP-1 and IL-6 levels suffered a higher risk of spontaneous preterm birth.ROC curve analysis denoted that the area under the curve(AUC)o

关 键 词：妊娠糖尿病 自发性早产 胎儿纤维连接蛋白 单核细胞趋化蛋白-1 白介素-6 

分 类 号：R714.2[医药卫生—妇产科学]