| 林小满,韩秋峪,郭 欣,杨国臣,张洪文,谢 娜,穆文玉.血清25（OH）D、IGFBP-1、STAT4与重度子痫前期患者自发性流产的关系分析[J].,2024,(2):289-293 |
| 血清25（OH）D、IGFBP-1、STAT4与重度子痫前期患者自发性流产的关系分析 |
| Analysis of the Relationship between Serum 25(OH)D, IGFBP-1, STAT4 and Spontaneous Abortion in Patients with Severe Preeclampsia |
| 投稿时间：2023-06-06 修订日期：2023-06-29 |
| DOI：10.13241/j.cnki.pmb.2024.02.016 |
| 中文关键词: 重度子痫前期 25（OH）D IGFBP-1 STAT4 自发性流产 |
| 英文关键词: Severe preeclampsia 25(OH)D IGFBP-1 STAT4 Spontaneous abortion |
| 基金项目:江苏省妇幼保健协会科研项目（FYX202023） |
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| 中文摘要: |
| 摘要 目的：探讨血清25-羟基维生素D[25（OH）D]、胰岛素生长因子结合蛋白1（IGFBP-1）、信号转导和转录激活因子4（STAT4）与重度子痫前期（PE）患者自发性流产的关系。方法：选取2020年1月到2022年12月于徐州医科大学附属医院治疗的重度PE患者150例。根据妊娠28周内是否发生自发性流产分为发生组（n=41）和未发生组（n=109）。对比两组血清25（OH）D、IGFBP-1、STAT4水平。收集两组患者的临床资料，多因素Logistic回归分析重度PE患者自发性流产的影响因素。受试者工作特征（ROC）曲线分析血清25（OH）D、IGFBP-1、STAT4水平对重度PE患者自发性流产的预测价值。结果：发生组的25（OH）D、IGFBP-1水平低于未发生组，STAT4水平高于未发生组（P<0.05）。重度PE患者自发性流产与年龄、PE发病孕周、孕前体质量指数（BMI）、分娩史、收缩压（SBP）、舒张压（DBP）、血小板计数（PLT）、肌酐（Scr）无关（P>0.05），而与流产史、D-二聚体（D-D）、白蛋白（ALB）、同型半胱氨酸（Hcy）、纤维蛋白原有关（P<0.05）。多因素Logistic回归分析结果显示， 25（OH）D下降、IGFBP-1下降、STAT4升高、有流产史、D-D升高、ALB下降、Hcy升高均是重度PE患者自发性流产的危险因素，而纤维蛋白原升高则是重度PE患者自发性流产的保护因素（P<0.05）。血清25（OH）D、IGFBP-1、STAT4联合检测预测自发性流产的曲线下面积（AUC）为0.960，高于单独指标预测。结论：重度PE患者血清25（OH）D、IGFBP-1下降，STAT4水平升高易导致自发性流产，自发性流产的发生还与流产史、D-D、ALB、Hcy、纤维蛋白原水平等因素有关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between serum 25-hydroxyvitamin D [25 (OH)D], insulin growth factor binding protein 1 (IGFBP-1), signal transducer and activator of transcription 4 (STAT4) and spontaneous abortion in patients with severe preeclampsia (PE). Methods: 150 severe PE patients who were treated in the Affiliated Hospital of Xuzhou Medical University from January 2020 to December 2022 were selected. Patients were divided into occurrence group (n=41) and non-occurrence group (n=109) according to whether spontaneous abortion occurred within 28 weeks of pregnancy. The levels of serum 25(OH)D, IGFBP-1 and STAT4 were compared between two groups. The clinical data in two groups were collected, and the influencing factors of spontaneous abortion in severe PE patients were analyzed by multivariate Logistic regression. The predictive value of serum 25(OH)D, IGFBP-1 and STAT4 levels for spontaneous abortion in severe PE patients were analyzed by receiver operating characteristic (ROC) curve. Results: The levels of 25(OH)D and IGFBP-1 in occurrence group were lower than those in non-occurrence group, and the level of STAT4 was higher than that in non-occurrence group (P<0.05). Spontaneous abortion in severe PE patients was not related to age, gestational age of PE onset, pre-pregnancy body mass index (BMI), delivery history, systolic blood pressure (SBP), diastolic blood pressure (DBP), platelet count (PLT) and creatinine (Scr) (P>0.05), but was related to abortion history, D-dimer (D-D), albumin (ALB), homocysteine (Hcy) and fibrinogen (P<0.05). Multivariate logistic regression analysis showed that, the decrease of 25(OH)D, the decrease of IGFBP-1, the increase of STAT4, abortion history, the increase of D-D, the decrease of ALB and the increase of Hcy were the risk factors of spontaneous abortion in severe PE patients, while the increase of fibrinogen was the protective factor of spontaneous abortion in severe PE patients (P<0.05). The area under the curve (AUC) of combined detection of serum 25(OH)D, IGFBP-1 and STAT4 in predicting spontaneous abortion was 0.960, which was higher than that of single index prediction. Conclusion: The decrease of serum 25(OH)D and IGFBP-1 and the increase of STAT4 level in severe PE patients are likely to lead to spontaneous abortion, the occurrence of spontaneous abortion is also relate to abortion history, D-D, ALB, Hcy, fibrinogen level and other factors. |
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