Objective To explore the changes of serum tissue inhibitor of metalloproteinase-1(TIMP-1)and extracellular matrix protein-3(Fibulin-3)levels after the first delivery,and their diagnostic value for postpartum pelvic floor dysfunction(PFD),and provide a reference for clinical research of PFD.Methods A total of 98 patients with PFD admitted to Chengde Maternal and Child Health Hospital from June 2021 to June 2022 were selected as study subjects,and the patients were categorized into the pure pelvic prolapse(POP)group(n=34),the pure stress urinary incontinence(SUI)group(n=51),and the POP-combined SUI group(n=13).In the same period,98 women who underwent postpartum review for primiparous delivery without PFD were selected as the control group.Serum TIMP-1 and Fibulin-3 levels were compared between the groups.The predictive efficacy of serum TIMP-1 and Fibulin-3 levels for PFD was analyzed by ROC.Results The proportion of patients with prolonged duration of the second stage of labor in the PFD group was higher than that in the control group,and the difference was statisticlly significant(x2=20.933,P＜0.05).Serum TIMP-1(3.68±0.41ng/ml)and Fibulin-3(28.18±2.29ng/ml)levels in the PFD group were lower than those in the control group(4.25±0.53ng/ml,23.04±2.64ng/ml),and the differenes were statistically significant(t=8.421,8.101,all P＜0.05).Serum TIMP-1 and Fibulin-3 levels in the POP combined with SUI group were lower than those in the POP alone group and SUI-only group(F=21.940,14.871,all P＜0.05).As the condition of the patients in the POP-only group and the SUI-only group worsened,the serum TIMP-1 andFibulin-3 levels were gradually decreased(F=8.411,13.173,18.425,10.965,all P＜0.05).ROC curves showed that the AUCs of serum TIMP-1 and Fibulin-3 alone and the combination of the two for the prediction of the occurrence of PFD were 0.770,0.784 and 0.893,respectively,which the AUC of combination detection was superior to that of the test alone(Z=2.996,2.766,all P＜0.05).Conclusion Serum TIMP-1 and Fibulin-3 levels are reduced in patients with PFD,and the combined predictive efficacy of the two is higher than that of the alone tests,which can be used as a serologic predictor of postpartum PFD.
关键词
盆底功能障碍/金属蛋白酶抑制因子-1/细胞外基质蛋白-3
Key words
pelvic floor dysfunction/tissue inhibitor of metalloproteinase-1/Fibulin-3
维普
万方数据