孕早期同型半胱氨酸联合外周血淋巴亚群对不明原因复发性流产的预测价值研究
A study on predictive value of combined early pregnancy homocysteine levels and peripheral blood lymphocyte subsets for unexplained recurrent spontaneous abortion
邵文嘉 1王国倩 2崔金全1
作者信息
- 1. 郑州大学第二附属医院妇产科,郑州 450000
- 2. 武汉市中心医院,武汉 430014
- 折叠
摘要
目的 探究孕早期同型半胱氨酸水平联合外周血淋巴细胞亚群监测对预测不明原因复发性流产的价值.方法 选取2020年9月至2023年3月于郑州大学第二附属医院保胎病房入院的172例不明原因型复发性流产的孕妇为研究对象,入院后均在24 h内完成外周血同型半胱氨酸及淋巴亚群检测.研究对象根据是否在妊娠28周前经历妊娠丢失被划分为流产组和继续妊娠组.运用logistic多因素回归分析,以筛选与不明原因复发性流产患者妊娠结局关联的因素.通过受试者工作特征曲线(ROC)分析,评估这些因素预测流产的临床价值.结果 172例孕妇中发生流产87例,继续妊娠85例.logistic多因素分析显示,同型半胱氨酸(HCY)、NK淋巴细胞、B淋巴细胞及Th/Ts百分比水平,这些因素已被证实对不明原因复发性流产患者的妊娠结局产生影响(P＜0.05).ROC分析显示,孕早期患者外周血HCY、NK细胞、B细胞和Th细胞/Ts细胞百分比单独及联合预测不明原因型复发性流产妊娠结局的AUC分别为0.781(95％CI:0.713～0.849)、0.684(95％CI:0.604～0.764)、0.711(95％CI:0.633～0.788)、0.710(95％CI:0.634～0.785)、0.873(95％CI:0.822～0.925).结论 孕早期检测同型半胱氨酸和外周血淋巴细胞亚群,对预测不明原因复发性流产患者的妊娠结局具有价值,尤其共同检测时预测效能可以提高.
Abstract
Objective To explore the predictive potential of early pregnancy homocysteine levels alongside peripheral blood lymphocyte subsets for unexplained recurrent spontaneous abortion(URSA).Methods We enrolled 172 pregnant women with a history of URSA admitted to the Fetal Protection Ward of the Second Affiliated Hospital of Zhengzhou Uni-versity covering the period from September 2020 to March 2023.All patients were tested for homocysteine and peripheral blood lymphocyte subsets within 24 hours after admission.The study population was categorized into a miscarriage group and a continuing pregnancy group based on whether patients experienced a miscarriage before 28 weeks of gestation.Logis-tic multiple regression analysis was utilized to ascertain factors that exerted an impact on pregnancy outcomes among indi-viduals experiencing unexplained recurrent miscarriage.The efficacy of these factors in predicting miscarriage was assessed through receiver operating characteristic(ROC)curve analysis.Results Among 172 pregnant women,87 had abortion and 85 had ongoing pregnancy.Multivariate analysis showed that homocysteine(HCY),NK cells,B cells and the per-centage of Th/Ts were all associated with pregnancy outcomes in women with unexplained recurrent miscarriage(P＜0.05).ROC curve analysis indicated that the AUC values of homocys-teine,NK cells,B cells and Th/Ts ratio in early pregnant URSA patients for predicting pregnancy outcomes were 0.781(95％CI:0.713～0.849),0.684(95％CI:0.604～0.764),0.711(95％CI:0.633～0.788),0.710(95％CI:0.634～0.785),0.873(95％CI:0.822～0.925),respectively.Conclusion The detection of homocysteine and peripheral blood lymphocyte subsets in early pregnancy is valuable for predicting pregnancy outcomes of URSA patients,and the combined detection has higher predictive efficiency.
关键词
不明原因复发性流产/同型半胱氨酸/外周血淋巴亚群/预测Key words
Unexplained recurrent spontaneous abortion/Homocysteine/Peripheral blood lymphocyte subsets/Prediction引用本文复制引用
基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20200409)
出版年
2024
NETL
NSTL
万方数据