摘要
目的 分析基于血清非对称性二甲基精氨酸(ADMA)、白细胞介素-18(IL-18)、胎盘生长因子(PIGF)、降钙素原(PCT)水平构建B型链球菌(GBS)感染孕妇不良妊娠结局的风险预测模型,对GBS感染孕妇不良妊娠结局的预测价值.方法 选取2021 年5 月—2022 年5 月80 例GBS感染孕妇作为研究组,同期未发生GBS感染的健康孕妇作为对照组,比较2 组血清ADMA、IL-18、PIGF、PCT水平.另对研究组孕妇随访至分娩,根据妊娠结局分为良好组与不良组,采用单因素、多因素Logistic回归分析探讨血清ADMA、IL-18、PIGF、PCT水平与GBS感染孕妇不良妊娠结局的关系.并采用受试者工作特征(ROC)曲线分析基于血清ADMA、IL-18、PIGF、PCT水平构建的风险预测模型对GBS感染孕妇不良妊娠结局的预测效能.结果 研究组血清ADMA、IL-18、PCT水平显著高于对照组,血清PIGF水平显著低于对照组(P＜0.01).多因素Logistic回归分析结果显示,ADMA(高)、IL-18(高)、PCT(高)、PIGF(低)、IgA(低)、IgM(低)、IgG(低)、合并糖尿病、合并高血压是GBS感染孕妇发生不良妊娠结局的危险因素(P＜0.05,P＜0.01).基于血清ADMA、IL-18、PIGF、PCT水平构建的风险预测模型预测GBS感染孕妇不良妊娠结局的敏感度、准确度、阳性预测值、曲线下面积分别为 93.67%、91.12%、90.38%、0.933.结论 基于血清ADMA、IL-18、PIGF、PCT水平构建的GBS感染孕妇不良妊娠结局风险预测模型,可较为准确地预测GBS感染孕妇的妊娠结局.
Abstract
Objective To analyze the establishment of a risk prediction model of adverse pregnancy outcomes in preg-nant women infected with type B streptococcus(GBS)based on serum levels of asymmetric dimethylarginine(ADMA),inter-leukin-18(IL-18),placental growth factor(PIGF)and procalcitonin(PCT),and its predictive value for adverse pregnancy outcomes in pregnant women infected with GBS.Methods From May 2021 to May 2022,80 pregnant women with GBS in-fection were selected as the research group,and healthy pregnant women without GBS infection were selected as the control group.Serum levels of ADMA,IL-18,PIGF and PCT were compared between the two groups.Pregnant women in the re-search group were followed up until delivery and divided into good and bad groups according to pregnancy outcomes.Univari-ate and multivariate Logistic regression were used to explore the relationship between serum levels of ADMA,IL-18,PIGF and PCT and adverse pregnancy outcomes of GBS-infected pregnant women.The predictive efficiency of the risk prediction model for adverse pregnancy outcomes in GBS-infected pregnant women based on serum ADMA,IL-18,PIGF and PCT levels was analyzed by receiver operating characteristic(ROC)curve.Results The serum levels of ADMA,IL-18 and PCT in the re-search group were significantly higher than those in the control group,while the serum PIGF level was significantly lower than that in the control group(P＜0.01).Multivariate Logistic regression analysis showed that ADMA(high),IL-18(high),PCT(high),PIGF(low),IgA(low),IgM(low),IgG(low),diabetes mellitus and hypertension were risk factors for ad-verse pregnancy outcomes for GBS-infected pregnant women(P＜0.05,P＜0.01).The sensitivity,accuracy,positive pre-dictive value and area under the ROC curve(AUC)of the risk prediction model based on serum ADMA,IL-18,PIGF and PCT levels in predicting adverse pregnancy outcomes of GBS-infected pregnant women were 93.67%,91.12%,90.38%and 0.933,respectively.Conclusion Based on serum ADMA,IL-18,PIGF and PCT levels,the risk prediction model of ad-verse pregnancy outcome in GBS-infected pregnant women can predict pregnancy outcome more accurately.
维普
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