目的 分析血清孕酮(P)和全血炎症标志物对孕早期先兆流产(TA)妊娠结局的预测效能.方法 纳入2021年6月至2023年7月期间在我院产科和妇科就诊的853例TA孕妇.使用商用ARCHITECT孕酮试剂盒测量血清P水平.使用Beckman Coulter血液计数分析仪进行全血细胞计数检测.记录妊娠13周时的妊娠结局.结果 流产组孕妇的中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)水平高于非流产组(P＜0.05).流产组孕妇的血清P水平明显低于非流产组[59.61(17.86,85.45)nmol/L vs 82.68(64.19,117.60)nmol/L,Z=-6.802,P＜0.001].血清 P 水平＜66.38nmol/L、NLR≥2.94、MLR≥0.20均为TA孕妇发生流产的独立危险因素(P＜0.05).P+NLR+MLR联合预测TA孕妇流产的受试者工作特征曲线下面积为0.797(95％CI 0.737～0.857),阳性似然比为3.14,明显优于3者单独预测.结论 除血清P外,NLR、MLR可用作预测TA孕妇孕早期妊娠结局的附加指标.
Prognostic Effects of Serum Progesterone and Whole Blood Inflammatory Markers on Pregnancy Outcomes of Threatened Abortion in Early Pregnancy Stage
Objective To evaluate the predictive efficacy of serum progesterone(P)and whole blood inflammatory markers on pregnancy outcomes of threatened abortion(TA)during the early pregnancy stage.Methods 853 TA pregnant women who attended the Department of Obstetrics and Gynecology of our hospital from June,2021 to July,2023 were included for the study.Serum P levels were measured using the commercial ARCHITECT progesterone kit.A complete blood count was performed using the Beckman Coulter blood count analyzer.Pregnancy outcomes at 13 weeks of gestation were recorded.Results Levels of neutrophil to lymphocyte ratio(NLR)and monocyte to lymphocyte ratio(MLR)in the abortion group were higher than those in the non-abortion group(P＜0.05).The serum P level in the aborted group was significantly lower than that in the non-aborted group[59.61(17.86,85.45)nmol/L vs 82.68(64.19,117.60)nmol/L,Z=-6.802,P＜0.001].P＜66.38 nmol/L,NLR≥2.94,MLR≥0.20 were identified as independent risk factors for abortion in TA pregnant women(P＜0.05).AUC of the combined prediction of TA pregnancy abortion by P+NLR+MLR was 0.797(95％CI 0.737-0.857),and the positive likelihood ratio was 3.14,which was significantly better than the three individual predictions.Conclusion In addition to serum P,NLR and MLR can be used as additional indicators to predict pregnancy outcomes in the first trimester of TA pregnant women.
ProgesteroneWhole blood inflammatory markersEarly pregnancyThreatened abortionNeutrophil to lymphocyte ratioMonocyte to lymphocyte ratio
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