摘要
目的 检测孕妇血清信号转导和转录激活因子3(signal transducer and activator of transcription 3,STAT3)、脂质运载蛋白2(lipocalin-2,LCN2)水平,探讨孕妇血清STAT3、LCN2检测联合彩色多普勒超声对胎儿窘迫的预测价值.方法 选取2020年5月至2022年5月西北妇女儿童医院收治的疑似胎儿窘迫的181例孕妇作为研究对象,收集其基线资料,根据胎儿窘迫诊断标准分为窘迫组89例和非窘迫组92例.采用超声诊断仪检查胎儿大脑中动脉血流参数收缩末期峰值与舒张末期峰值的比值(umbilical artery end systolic peak/end diastolic peak,S/D)、搏动指数(pulsatility index,PI)、阻力指数(resistant index,RI),采用酶联免疫吸附法测定血清STAT3、LCN2水平;采用多因素Logistic回归分析检验彩色多普勒超声参数及血清STAT3、LCN2水平与胎儿窘迫的关系;绘制受试者操作特征(receiver operator characteristic,ROC)曲线检验彩色多普勒超声参数及血清STAT3、LCN2水平对胎儿窘迫的预测价值.结果 窘迫组血清STAT3、LCN2水平及阿普加评分、S/D、PI、RI低于非窘迫组,差异有统计学意义(P<0.05).彩色多普勒超声参数S/D、PI、RI及血清STAT3、LCN2均与胎儿窘迫相关(P<0.05).S/D、PI、RI及血清STAT3、LCN2水平及五者联合预测胎儿窘迫的曲线下面积分别为0.798、0.770、0.771、0.861、0.774、0.956,95%CI分别为0.732～0.864、0.703～0.838、0.699～0.844、0.805～0.917、0.705～0.843、0.927～0.985.两组一般资料差异无统计学意义(P>0.05).结论 孕妇血清STAT3、LCN2水平降低可能与胎儿窘迫发生有关,二者与彩色多普勒超声参数S/D、PI、RI联合可有效预测胎儿窘迫.
Abstract
Objective To measure the levels of signal transducer and activator of transcription 3(STAT3)and lipoprotein 2(LCN2)in maternal serum,and to explore the predictive value of maternal serum STAT3 and LCN2 combined with color doppler ultrasound for fetal distress.Methods A total of 181 pregnant women suspected of fetal distress admitted to Northwest Women's and Children's Hospital from May 2020 to May 2022 were selected as the study subjects,the baseline data were recorded and grouped into 89 cases of distress group and 92 cases of non-distress group according to the diagnostic criteria for fetal distress.The ratio of blood flow parameters of fetal middle cerebral artery end systolic peak to end diastolic peak(S/D),pulsatility index(PI)and resistance index(RI)in fetal middle cerebral artery were examined with ultrasonic diagnostic apparatus,the levels of serum STAT3 and LCN2 were measured by ELISA;multivariate Logistic regression analysis was applied to examine the relationship between color doppler ultrasound parameters,serum STAT3,LCN2 levels and fetal distress;ROC curve was drawn to test the predictive value of color doppler ultrasound parameters and serum STAT3,LCN2 levels for fetal distress.Results The levels of serum STAT3,LCN2,Apgar score,S/D,PI and RI in the distress group were lower than those in the non-distress group and the differences were statistically significant(P<0.05).Color doppler ultrasound parameters S/D,PI,RI,serum STAT3 and LCN2 were correlated with fetal distress(P<0.05).The area under the curve(AUC)of S/D,PI,RI,serum STAT3 and LCN2 levels and their combined prediction of fetal distress was 0.798,0.770,0.771,0.861,0.774 and 0.956,respectively,95%CI values were 0.732-0.864,0.703-0.838,0.699-0.844,0.805-0.917,0.705-0.843,0.927-0.985,respectively.There is no statistically significant difference in the general information between the two groups(P>0.05).Conclusions The decrease of serum STAT3 and LCN2 levels in pregnant women may be related to the occurrence of fetal distress.The combination of STAT3 and LCN2 levels with color doppler ultrasound parameters S/D,PI,RI can effectively predict fetal distress.
维普
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