摘要
目的 探究血清可溶性转铁蛋白受体(sTFR)、维生素D(VD)水平在高龄妊娠期缺铁性贫血(IDA)孕妇中的表达及其对妊娠结局的预测价值.方法 回顾性选取2020年3月至2023年3月间在邢台医专第二附属医院进行产检确诊的96例高龄妊娠期IDA孕妇纳入研究组;另选取本院同期健康孕妇100例纳入对照组.检测两组孕妇血清sTFR、VD水平.对研究组孕妇随访至分娩,观察其妊娠结局,分析影响研究组孕妇妊娠结局的因素,受试者工作特征(ROC)曲线下面积(AUC)分析sTFR、VD对研究组孕妇妊娠结局的预测价值.结果 研究组sTFR水平高于对照组,VD水平低于对照组(P＜0.05).不良妊娠结局孕妇年龄、有不良孕产史占比、贫血程度为重度占比、伴有孕期生殖道感染占比、sTFR水平均高于良好妊娠结局孕妇,VD水平低于良好妊娠结局孕妇(P＜0.05).多因素逐步Lo-gistic 回归分析显示,年龄(OR=2.075,95％CI:1.215～3.543)、贫血程度(OR=3.034,95％CI:1.486～6.192)、sTFR水平(OR=5.465,95％CI:2.227～13.410)是IDA孕妇发生不良妊娠结局的独立危险因素,VD水平(OR=0.237,95％CI:0.107～0.521)是独立保护因素(P＜0.05).ROC曲线显示,sTFR、VD及二者联合预测孕妇妊娠结局的灵敏度分别为 74.20％、77.40％、93.50％,特异度分别为 76.90％、67.70％、64.60％,AUC 分别为 0.814、0.788、0.904(P＜0.05).结论 IDA孕妇血清中sTFR水平异常高表达、VD水平异常低表达,sTFR是IDA孕妇不良妊娠结局的独立危险因素,VD是独立保护因素.临床联合测定sTFR、VD水平可较好的预测IDA孕妇不良妊娠结局发生情况.
Abstract
Objective To investigate the expression of serum soluble transferrin receptor(sTFR)and vitamin D(VD)levels in pregnant women with iron deficiency anemia(IDA)at advanced maternal age and its predictive value for pregnancy outcomes.Methods A total of 96 elderly pregnant women with IDA diagnosed by prenatal examination in Obstetrics and Gynecology Department of Xingtai Medical College Second Affiliated Hospital from March 2020 to March 2023 were retrospectively selected as the study group.Another 100 healthy pregnant women in our hospital dur-ing the same period were selected as the control group.Detection of two groups of pregnant women serum sTFR,VD level.For team childbirth,pregnant women were followed to observe the pregnancy outcome,analyze the factors affect-ing the team pregnancy outcomes of pregnant women,the area under the receiver-operating characteristic(ROC)curve(AUC)analysis sTFR,the predictive value of VD in pregnant women team pregnancy outcome.Results sTFR levels of teams is higher than the control group,VD level is lower than the control group(P＜0.05).Compared with those with good pregnancy outcomes,women with adverse pregnancy outcomes had a significantly higher age,a significantly higher proportion of women with a history of adverse pregnancy and childbirth,a significantly higher proportion of women with severe anemia,a significantly higher proportion of women with reproductive tract infection during pregnan-cy,and a significantly higher sTFR level,while a significantly lower VD level(P＜0.05).Multi-factor stepwise Logistic regression analysis showed that age(OR=2.075,95％CI:1.215 3.543),the degree of anemia(OR=3.034,95％CI:1.486 6.192),the level of sTFR(OR=5.465,95％CI:2.227～13.410)is IDA pregnant women independent risk fac-tors for adverse pregnancy outcomes,VD level(OR=0.237,95％CI:0.107 0.521)were independent protective factors(P＜0.05).ROC curve shows that sTFR,VD,and the two combined to predict the sensitivity of the pregnant women pregnancy outcomes were 74.20％,77.40％,93.50％,specificity of 76.90％,67.70％,64.60％respectively,AUC are 0.814,0.788,0.904 respectively(P＜0.05).Conclusion Pregnant women with IDA have abnormally high expression of sTFR and abnormally low expression of VD.sTFR is an independent risk factor for adverse pregnancy outcomes in pregnant women with IDA,and VD is an independent protective factor.Clinical combined determination of sTFR and VD levels can better predict the occurrence of adverse pregnancy outcomes in pregnant women with IDA.
维普
万方数据