| 李 杨,聂 岚,刘虹璐,尹海燕,罗 婷.子宫动脉血流参数联合血清PLGF、 PAPP-A预测早孕期不明原因复发性流产孕妇妊娠结局的临床研究[J].,2023,(15):2910-2914 |
| 子宫动脉血流参数联合血清PLGF、 PAPP-A预测早孕期不明原因复发性流产孕妇妊娠结局的临床研究 |
| Clinical Study of Uterine Arterial Blood Flow Parameters Combined with Serum PLGF and PAPP-A in Predicting Pregnancy Outcome of Pregnant Women with Unexplained Recurrent Spontaneous Abortion during Early Pregnancy |
| 投稿时间：2023-01-30 修订日期：2023-02-27 |
| DOI：10.13241/j.cnki.pmb.2023.15.021 |
| 中文关键词: 子宫动脉血流参数 PLGF PAPP-A 早孕期 不明原因复发性流产 妊娠结局 预测价值 |
| 英文关键词: Uterine arterial blood flow parameters PLGF PAPP-A Early pregnancy Unexplained recurrent spontaneous abortion Pregnancy outcome Predictive value |
| 基金项目:湖南省卫生健康委卫生科研项目（D202305019145） |
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| 中文摘要: |
| 摘要 目的：探讨子宫动脉血流参数联合血清胎盘生长因子（PLGF）、妊娠相关血浆蛋白-A（PAPP-A）对早孕期不明原因复发性流产（URSA）孕妇妊娠结局的预测价值。方法：选取2021年10月-2022年10月我院收治的103例有URSA史的妊娠期孕妇。追踪其妊娠28周的妊娠结局，根据不同妊娠结局将其分为正常妊娠组（n=26）与流产组（n=77）。比较两组子宫动脉血流参数[阻力指数（RI）、搏动指数（PI）、收缩期峰值流速/舒张末期流速（S/D）]及血清PLGF、PAPP-A水平。多因素Logistic回归模型分析早孕期URSA孕妇妊娠结局的影响因素。受试者工作特征（ROC）曲线分析子宫动脉血流参数联合血清PLGF、PAPP-A对早孕期URSA孕妇妊娠结局的预测价值。结果：流产组PI、RI、S/D显著高于正常妊娠组（P＜0.05），血清PLGF、PAPP-A水平显著低于正常妊娠组（P＜0.05）。Logistic回归模型显示，PI、RI、S/D升高为早孕期URSA孕妇妊娠结局的危险因素（P＜0.05），血清PLGF、PAPP-A水平升高则为保护性因素（P＜0.05）。ROC分析结果发现，PI、RI、S/D、PLGF、PAPP-A联合预测早孕期URSA孕妇妊娠结局的效能最高，联合诊断的曲线下面积（AUC）为0.913，显著优于各项指标单独诊断。结论：子宫动脉血流参数联合血清PLGF、PAPP-A预测早孕期URSA孕妇妊娠结局的价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the value of uterine arterial blood flow parameters combined with serum placental growth factor (PLGF) and pregnancy associated plasma protein-A (PAPP-A) in predicting the pregnancy outcome of pregnant women with unexplained recurrent spontaneous abortion (URSA) during early pregnancy. Methods: 103 pregnant women with URSA history who were admitted to our hospital from October 2021 to October 2022 were selected. Their pregnancy outcome at 28 weeks were tracked, and they were divided into normal pregnancy group (n=26) and abortion group (n=77) according to different pregnancy outcome. The uterine artery blood flow parameters [resistance index (RI), pulsation index (PI), peak systolic flow velocity/end-diastolic flow velocity (S/D)] and serum PLGF and PAPP-A levels were compared in the two groups. Multivariate Logistic regression model was used to analyze the influencing factors of pregnancy outcome of pregnant women with URSA during early pregnancy. The predictive value of uterine artery blood flow parameters combined with serum PLGF and PAPP-A for pregnancy outcome of pregnant women with URSA during early pregnancy was analyzed by receiver operating characteristic (ROC) curve. Results: The PI, RI and S/D in the abortion group were significantly higher than those in the normal pregnancy group (P＜0.05), while serum PLGF and PAPP-A levels were significantly lower than those in the normal pregnancy group (P＜0.05). Logistic regression model showed that the elevated PI, RI and S/D were the risk factor for pregnancy outcome of pregnant women with URSA during early pregnancy (P＜0.05), while the elevated serum PLGF and PAPP-A levels were the protective factor (P＜0.05). ROC analysis results showed that the combination of PI, RI, S/D, PLGF, and PAPP-A had the highest efficacy in predicting the pregnancy outcome of pregnant women with URSA during early pregnancy, and the area under the curve (AUC) of combined diagnosis was 0.913, which was significantly better than the diagnosis of each index alone. Conclusion: Uterine arterial blood flow parameters combined with serum PLGF and PAPP-A have high value in predicting pregnancy outcome of pregnant women with URSA during early pregnancy. |
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