摘要
目的 研究复发性流产(RSA)患者血浆抗凝血酶Ⅲ(AT-Ⅲ)、蛋白C、蛋白S活性水平变化,并分析对RSA的预测价值。方法 选取2020年8月至2022年8月郑州市妇幼保健院收治的101例RSA未孕患者为研究组,以1∶2比例选择同期有正常分娩史的202例健康未孕女性为对照组,均检测血浆蛋白S、AT-Ⅲ、蛋白C活性水平,并检测两组性激素[血清β-人绒毛膜促性腺激素(β-HCG)、孕酮、雌二醇]水平,分析血浆蛋白S、AT-Ⅲ、蛋白C活性水平与性激素的关系,观察不同流产次数RSA患者血浆蛋白S、AT-Ⅲ、蛋白C活性水平,并分析其对流产发生的预测价值。结果 研究组血浆蛋白S、AT-Ⅲ、蛋白C活性水平及血清β-HCG、孕酮、雌二醇水平均低于对照组,差异有统计学意义(P <0.05);血浆蛋白S、AT-Ⅲ、蛋白C活性水平与血清β-HCG、孕酮、雌二醇水平均呈正相关关系,差异有统计学意义(P <0.05);不同流产次数RSA患者血浆蛋白S、AT-Ⅲ、蛋白C活性水平对比,3次> 4次> 4次以上,差异有统计学意义(P <0.05);蛋白S、AT-Ⅲ、蛋白C活性水平诊断RSA的AUC均大于0.7,联合诊断RSA的AUC为0.907;以ROC分析的cut-off值作为分界点,蛋白S、AT-Ⅲ、蛋白C所致的RR值分别为5.538(2.210~13.882)、2.290(1.568~3.346)、2.946(1.651~5.259),差异有统计学意义(P <0.05)。结论 血浆AT-Ⅲ、蛋白C、蛋白S活性水平变化与RSA患者性激素水平及流产次数有关,联合检测对再次流产的预测效能较高,可为RSA患者临床干预、病情改善提供合理依据。
Objective To study the changes in the plasma activity levels of antithrombin Ⅲ(AT-Ⅲ), protein C, and protein S in patients with recurrent abortion(RSA), and to analyze the predictive value of RSA. Methods A total of 101 unpregnant RSA patients admitted to Zhengzhou Maternal and Child Health Hospital from August 2020 to August 2022 were selected as the research group, and 202 healthy unpregnant women with a history of normal delivery in the same period at a ratio of 1:2were selected as the control group. Level of plasma protein S, AT-Ⅲ, protein C, and sex hormone [serum β-human chorionic gonadotropin(β-HCG), progesterone, estradiol]in two groups were tested, the relationship between plasma protein S, AT-Ⅲ,protein C activity level and sex hormone were analyzed, and the plasma protein S, AT-Ⅲ, protein C activity level in different abortion patients were observed and their predictive value for the occurrence of abortion were analyzed. Results The activity levels of plasma protein S, AT-Ⅲ, protein C activity level and serum β-HCG, progesterone and estradiol in the study group were lower than those in the control group, and the differences were significant(P < 0.05);Activity levels of plasma protein S, AT-Ⅲ,and protein C were positively associated with serum β-HCG, progesterone, and estradiol levels, with significant differences(P <0.05);Comparison of plasma protein S, AT-Ⅲ, and protein C activity levels in RSA patients with different abortion times, 3 >4 > 4 more times, with significant difference(P < 0.05);The AUC of protein S, AT-Ⅲ and protein C activity level for diagnostic RSA was greater than 0.7, and the AUC for combined diagnosis of RSA was 0.907;Using the cut-off value of ROC analysis as the cut-off point, the RR values due to protein S, AT-Ⅲ, and protein C were 5.538(2.210 ~ 13.882), 2.290(1.568 ~ 3.346),and 2.946(1.651 ~ 5.259), respectively, which showed statistically significant differences(P < 0.05). Conclusion The changes of plasma AT-Ⅲ, protein C and protein S activity levels are related to the changes of sex hormone level and the number of abortions in RSA patients. Combined detection has higher predictive efficacy for second abortion, which can provide reasonable basis for clinical intervention and disease improvement in RSA patients.
作者
卜雪瑞
僧雪雁
BU Xuerui;SENG Xueyan(Department of Clinical Laboratory,Zhengzhou Maternal and Child Health Care Hospital,Zhengzhou Henan 450000,China;Department of Eugenics,Zhengzhou Maternal and Child Health Care Hospital,Zhengzhou Henan 450000,China)
出处
《临床研究》
2023年第2期4-7,共4页
Clinical Research
