现代检验医学杂志2024，Vol.39Issue(1) ：106-111.DOI:10.3969/j.issn.1671-7414.2024.01.019

先兆流产保胎治疗孕妇血清PCSK9和CTRP6水平对妊娠结局的预测价值研究

Predictive Value of Serum PCSK9 and CTRP6 in Pregnant Women Undergoing Threatened Abortion and Fetal Protection Treatment on Pregnancy Outcomes

段宁娟 刘燕 王振威
现代检验医学杂志2024，Vol.39Issue(1) ：106-111.DOI:10.3969/j.issn.1671-7414.2024.01.019
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先兆流产保胎治疗孕妇血清PCSK9和CTRP6水平对妊娠结局的预测价值研究

Predictive Value of Serum PCSK9 and CTRP6 in Pregnant Women Undergoing Threatened Abortion and Fetal Protection Treatment on Pregnancy Outcomes

段宁娟 1刘燕 2王振威3
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作者信息

  • 1. 陕西中医药大学第二附属医院产科,陕西咸阳 712000
  • 2. 西安医学院第一附属医院妇科,西安 710077
  • 3. 陕西中医药大学第二附属医院妇科,陕西咸阳 712000
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摘要

目的 探究先兆流产保胎治疗孕妇血清前蛋白转化酶枯草溶菌素9(proprotein convertase subtilisin/kexin type 9,PCSK9),C1q肿瘤坏死因子相关蛋白 6(complement-C1q/tumor necrosis factor-related protein 6,CTRP6)水平对妊娠结局的预测价值.方法 选取 2021 年 08 月～2022 年 05 月在陕西中医药大学第二附属医院行保胎治疗的80 例先兆流产孕妇为研究对象,根据妊娠结局将其分为良好妊娠结局组(n=62)、不良妊娠结局组(n=18);另选取同期在该院孕检正常的孕妇 60 例作为对照组.采用酶联免疫吸附法(ELISA)检测研究对象血清PCSK9,CTRP6,孕酮和β-人绒毛膜促性腺激素(β-HCG)水平;采用Pearson法分析血清PCSK9,CTRP6 水平与孕酮,β-HCG水平的相关性;采用多因素Logistic回归分析影响先兆流产保胎治疗孕妇妊娠结局的因素;采用受试者工作特征(ROC)曲线分析先兆流产保胎治疗孕妇血清PCSK9和CTRP6对妊娠结局的预测价值.结果 对照组、良好妊娠结局组和不良妊娠结局组的孕酮(45.65±3.48,38.29±3.54和31.56±4.11 nmol/L),β-HCG(32 056.56±4 244.54,23 642.32±3 897.67 和11 375.56±3 454.35 mIU/L),CTRP6(436.53±36.23,328.44±31.06和277.86±25.56 ng/ml)水平均呈逐渐降低趋势,PCSK9(64.22±10.35,82.24±13.33 和114.56±17.67 ng/ml)表达水平呈逐渐升高趋势,差异具有统计学意义(F=129.231,199.334,244.007,111.297,均P＜0.05).Pearson法分析显示,血清PCSK9 与孕酮、β-HCG水平呈负相关(r=-0.545,-0.514,均P＜0.05),血清CTRP6 与孕酮、β-HCG水平呈正相关(r=0.567,0.496,均P＜0.05).多因素Logistic回归分析显示,PCSK9 水平升高为先兆流产保胎治疗孕妇妊娠结局的独立危险因素,CTRP6,孕酮、β-HCG水平升高为先兆流产保胎治疗孕妇妊娠结局的独立保护因素(P＜0.05).ROC结果显示,先兆流产保胎治疗孕妇血清PCSK9,CTRP6 预测患者发生不良妊娠结局的曲线下面积(AUC)分别为 0.843,0.849,两者联合预测的AUC为 0.941,优于两者各自单独预测(Z=1.725,1.882,P＜0.05),且特异度和敏感度分别为 85.48%,94.44%.结论 先兆流产保胎治疗孕妇血清PCSK9 水平显著上调,CTRP6 水平显著下调,两者在预测先兆流产保胎治疗孕妇的妊娠结局中具有重要价值.

Abstract

Objective To explore the predictive value of serum proprotein convertase subtilisin/kexin type 9(PCSK9)and proprotein convertase subtilisin/kexin type 9(CTRP6)in pregnant women undergoing threatened abortion and fetal protection treatment for pregnancy outcomes.Methods Eighty pregnant women with threatened abortion who were treated in the Second Affiliated Hospital of Shaanxi University of Chinese Medicine from August 2021 to May 2022 were selected as the study subjects.According to the pregnancy outcome,they were grouped into the good pregnancy outcome group(n=62)and the bad pregnancy outcome group(n=18),while another 60 pregnant women with normal pregnancy tests in the hospital were selected as the control group.The serum levels of PCSK9,CTRP6,progesterone and β-human chorionic gonadotropin(β-HCG)were measured by enzyme-linked immunosorbent assay(ELISA).Pearson method was applied to analyze the correlation between serum PCSK9,CTRP6 levels and progesterone and β-HCG levels.Multivariate Logistic regression analysis was applied to analyze the factors affecting the pregnancy outcomes of pregnant women with threatened abortion.The predictive value of serum PCSK9 and CTRP6 on pregnancy outcome of pregnant women with threatened abortion and pregnancy protection treatment was analyzed by the receiver operating characteristic(ROC)curve.Results The level of progesterone(45.65±3.48,38.29±3.54 and 31.56±4.11 nmol/L),β-HCG(32 056.56±4 244.54,23 642.32±3 897.67 and 11 375.56±3 454.35 mIU/L)and CTRP6(436.53±36.23,328.44±31.06 and 277.86±25.56 ng/ml)in control group,good pregnancy outcome group and bad pregnancy outcome group decreased gradually,while the level of PCSK9(64.22±10.35,82.24±13.33 and 114.56±17.67 ng/ml)in the control group,the good pregnancy outcome group and the bad pregnancy outcome group increased gradually,with statistically significant differences(F=129.231,199.334,244.007,111.297,all P＜0.05).Pearson method showed that serum PCSK9 was negatively correlated with progesterone and β-HCG levels(r=-0.545,-0.514,all P＜0.05),and serum CTRP6 was positively correlated with progesterone and β-HCG levels(r=0.567,0.496,all P＜0.05).Multivariate Logistic regression analysis showed that the high level of PCSK9 was an independent risk factor for pregnancy outcome of threatened abortion and fetal protection treatment,and the high level of CTRP6,progesterone and β-HCG were independent protective factors for pregnancy outcome of threatened abortion and fetal protection treatment(P＜0.05).ROC results showed that the area under the curve(AUC)of serum PCSK9 and CTRP6 levels for patients with adverse pregnancy outcomes in the prediction of threatened abortion and fetal protection treatment was 0.843 and 0.849,respectively.The AUC predicted by the combination of the two was 0.941,which was better than that predicted by each individual(Z=1.725,1.882,P＜0.05),with a specificity and a sensitivity of 85.48%,94.44%,respectively.Conclusion The serum PCSK9 level of pregnant women undergoing threatened abortion and fetal protection treatment was obviously increased,and the level of CTRP6 was obviously reduced.This study indicated both have important value in predicting the pregnancy outcomes of pregnant women undergoing threatened abortion and fetal protection treatment.

关键词

前蛋白转化酶枯草溶菌素9/C1q肿瘤坏死因子相关蛋白6/先兆流产/妊娠结局

Key words

proprotein convertase subtilisin/kexin type 9/complement-C1q/tumor necrosis factor-related protein 6/threatened abortion/pregnancy outcome

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基金项目

陕西省卫生健康科研项目(2018D085)

出版年

2024
现代检验医学杂志
陕西省临床检验中心,陕西省人民医院

现代检验医学杂志

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影响因子：0.713
ISSN：1671-7414
参考文献量5
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