文章摘要
李小叶,刘叶君,李 慧,李德忠,蒋 静.自发性早产的影响因素及血清fFN、MCP-1、PAF的预测价值分析[J].,2022,(6):1142-1146
自发性早产的影响因素及血清fFN、MCP-1、PAF的预测价值分析
Influencing Factors of Spontaneous Preterm Birth and Predictive Value Analysis of Serum fFN, MCP-1 and PAF
投稿时间:2021-07-29  修订日期:2021-08-24
DOI:10.13241/j.cnki.pmb.2022.06.030
中文关键词: 自发性早产  影响因素  fFN  MCP-1  PAF  预测价值
英文关键词: Spontaneous preterm birth  Influencing factor  fFN  MCP-1  PAF  Predictive value
基金项目:湖南省自然科学基金项目(2019JJ80040)
作者单位E-mail
李小叶 湖南省妇幼保健院产一科 湖南 长沙 410028 youxiang19980720@163.com 
刘叶君 湖南省妇幼保健院产一科 湖南 长沙 410028  
李 慧 湖南省妇幼保健院产一科 湖南 长沙 410028  
李德忠 湖南省妇幼保健院产一科 湖南 长沙 410028  
蒋 静 湖南省妇幼保健院产一科 湖南 长沙 410028  
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中文摘要:
      摘要 目的:探讨自发性早产的影响因素,分析母体血清胎儿纤维连接蛋白(fFN)、单核细胞趋化蛋白1(MCP-1)、血小板激活因子(PAF)预测自发性早产的价值。方法:选取2019年6月至2020年6月于我院产科门诊产检的300例产妇为研究对象,其中45例发生自发性早产(早产组),255例未发生自发性早产(对照组)。两组受试者均于妊娠30周采集静脉血,检测血清fFN、MCP-1、PAF水平。收集相关资料,采用多因素Logistic回归分析影响自发性早产发生的因素。受试者工作特征曲线(ROC)分析fFN、MCP-1、PAF预测自发性早产的价值。结果:单因素分析结果显示早产组体质量指数<19 kg/m2、辅助生殖技术助孕、早产史、子宫颈手术史、妊娠间隔时间<18个月、妊娠期并发胎膜早破、妊娠期并发宫颈缩短、妊娠期间吸烟比例、血清fFN、MCP-1、PAF水平高于对照组(P<0.05)。多因素Logistic回归分析结果示妊娠期合并胎膜早破、宫颈缩短、早产史、fFN水平偏高、MCP-1水平偏高、PAF水平偏高等,是自发性早产的危险影响因素(OR>1,P<0.05)。fFN、MCP-1、PAF及其联合应用预测自发性早产的曲线下面积(AUC)(0.95CI)分别为0.736(0.480~0.990)、0.713(0.488~0.935)、0.735(0.495~0.967)、0.866(0.782~0.940),联合应用的预测效能高于单独指标。结论:妊娠期合并胎膜早破、宫颈缩短、早产史、血清fFN、MCP-1、PAF水平升高是自发性早产的危险因素,联合fFN、MCP-1、PAF水平可预测自发性早产风险。
英文摘要:
      ABSTRACT Objective: To investigate the influencing factors of spontaneous preterm birth, and to analyze the value of maternal fetal fibronectin(fFN), monocyte chemotactic protein 1(MCP-1) and platelet activating factor(PAF) in predicting spontaneous preterm birth. Methods: 300 pregnant women who underwent obstetric examination in the obstetric clinic of our hospital from June 2019 to June 2020 were selected as the research object, including 45 cases of spontaneous preterm birth (preterm birth group), 255 cases without spontaneous preterm birth (control group). Venous blood of both groups was collected at 30 weeks of gestation, the levels of serum fFN, MCP-1 and PAF were detected. The related data were collected, and multivariate Logistic regression was used to analyze the factors affecting the occurrence of spontaneous preterm birth. Receiver operating characteristic curve(ROC) was used to analyze the value of fFN, MCP-1 and PAF in predicting spontaneous preterm birth. Results: Univariate analysis showed that the body mass index < 19 kg/m2, assisted reproductive technology assisted pregnancy, history of preterm birth, history of cervical surgery, pregnancy interval time < 18 months, pregnancy complicated with premature rupture of membranes, pregnancy complicated with cervical shortening, the proportion of smoking during pregnancy, and the levels of serum fFN, MCP-1 and PAF in the preterm birth group were higher than those in the control group(P<0.05). Multivariate Logistic regression analysis showed that pregnancy complicated with premature rupture of membranes, cervical shortening, history of preterm birth, high level of fFN, high level of MCP-1 and high level of PAF were the risk factors of spontaneous preterm birth (OR>1, P<0.05). The area under the curve (AUC) (0.95CI) of fFN, MCP-1, PAF and their combined application in predicting spontaneous preterm birth were 0.736 (0.480~0.990), 0.713 (0.488~0.935), 0.735 (0.495~0.967) and 0.866 (0.782~0.940), respectively, the prediction efficiency of combined application was higher than that of single index. Conclusion: Pregnancy complicated with premature rupture of membranes, cervical shortening, history of preterm birth, elevated serum levels of fFN, MCP-1 and PAF are the risk factors of spontaneous preterm birth. Combined with the levels of FN, MCP-1 and PAF can predict the risk of spontaneous preterm birth.
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