摘要
目的探讨妊娠期亚临床甲状腺功能减退症(SCH)患者血清C1q肿瘤坏死因子相关蛋白9(CTRP9)、细胞间黏附分子-1(ICAM-1)水平及其与妊娠结局的关系。方法选取2021年2月至2022年2月在张家口市第五医院接受治疗的60例妊娠期SCH患者作为SCH组,另选取同期60例产前检查正常孕妇作为对照组。检测SCH组和对照组血清ICAM-1、CTRP9水平。根据妊娠结局将SCH组又分为妊娠结局良好组和妊娠结局不良组。采用Pearson相关分析ICAM-1、CTRP9水平与促甲状腺激素(TSH)水平的相关性。采用受试者工作特征(ROC)曲线分析血清ICAM-1、CTRP9对妊娠期SCH患者不良结局的预测价值。采用多因素Logistic回归分析发生不良妊娠结局的影响因素。结果SCH组血清ICAM-1水平高于对照组,CTRP9水平低于对照组,且妊娠不良组血清ICAM-1水平高于妊娠良好组,CTRP9水平低于妊娠良好组,差异均有统计学意义(P<0.05)。血清ICAM-1水平与TSH水平呈正相关(r=0.612,P<0.05),CTRP9水平与TSH水平呈负相关关系(r=-0.490,P<0.05)。ROC曲线分析结果显示,血清ICAM-1、CTRP9预测SCH患者不良妊娠结局的曲线下面积(AUC)分别为0.848(95%CI:0.769~0.927)、0.835(95%CI:0.763~0.908),二者联合检测的AUC为0.922(95%CI:0.874~0.971),大于二者单独检测。多因素Logistic回归分析结果显示,ICAM-1水平升高是不良妊娠结局的危险因素(P<0.05),CTRP9水平升高是不良妊娠结局的保护因素(P<0.05)。结论妊娠期SCH患者血清ICAM-1水平升高,CTRP9水平降低,与不良妊娠结局有一定关系,可能是不良妊娠结局的评估指标。
Objective To investigate serum C1q tumor necrosis factor-related protein 9(CTRP9)and intercellular adhesion molecule-1(ICAM-1)levels in patients with subclinical hypothyroidism(SCH)during pregnancy and their relationship with pregnancy outcomes.Methods A total of 60 SCH patients were treated in the Fifth Hospital of Zhangjiakou from February 2021 to February 2022 were selected as the SCH group,and 60 pregnant women with normal prenatal examination patients during the same period were selected as the control group.Serum ICAM-1 and CTRP9 levels were measured in SCH group and control group.According to the pregnancy outcome,the SCH group was further divided into good pregnancy outcome group and poor pregnancy outcome group.Pearson correlation analysis was used to analyze the correlation between ICAM-1,CTRP9 levels and thyroid stimulating hormone(TSH)levels.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum ICAM-1 and CTRP9 for adverse outcomes in patients with SCH during pregnancy.Multivariate Logistic regression was used to analyze the influencing factors of adverse pregnancy outcomes.Results The SCH group had significantly higher serum ICAM-1 level and significantly lower CTRP9 level than the control group(P<0.05),and the poor pregnancy group had significantly higher serum ICAM-1 level and significantly lower CTRP9 level than the good pregnancy group(P<0.05).Serum ICAM-1 level was positively correlated with TSH level(r=0.612,P<0.05),while CTRP9 level was negatively correlated with TSH level(r=-0.490,P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum ICAM-1 and CTRP9 for predicting adverse pregnancy outcomes in SCH patients was 0.848(95%CI:0.769-0.927)and 0.835(95%CI:0.763-0.908)respectively.The AUC of combined detection was 0.922(95%CI:0.874-0.971),which was greater than that of single detection.Multivariate Logistic regression analysis showed that increased ICAM-1 level was a risk factor for adverse pregnancy outcomes(P<0.05),and increased CTRP9 level was a protective factor for adverse pregnancy outcomes(P<0.05).Conclusion Serum ICAM-1 level increaseds and CTRP9 level decreaseds in patients with SCH during pregnancy,which is related to adverse pregnancy outcomes and may be an evaluation indicator for adverse pregnancy outcomes.
作者
张世芳
马海燕
刘晓静
ZHANG Shifang;MA Haiyan;LIU Xiaojing(Department of Obstetrics and Gynecology,the Fifth Hospital of Zhangjiakou,Zhangjiakou,Hebei 075000,China;Department of Gynecology,Hebei Huaoao Hospital,Zhangjiakou,Hebei 075000,China;Department of Neonatology,Zhangjiakou Maternal and Child Health Hospital,Zhangjiakou,Hebei 075000,China)
出处
《检验医学与临床》
CAS
2024年第22期3364-3368,共5页
Laboratory Medicine and Clinic
基金
河北省张家口市重点研发计划项目(2221191D)。
