血清维生素D、sPD-L1及HCG与复发性流产主动免疫治疗预后的关系研究

Study on the relationship between serum vitamin D,sPD-L1,HCG and prognosis of active immunotherapy for recurrent abortion

目的研究血清维生素D、可溶性程序性死亡分子配体1(sPD-L1)及人绒毛膜促性腺激素(HCG)水平与复发性流产主动免疫治疗预后的关系。方法选取2017年1月至2018年2月武汉市第三医院收治的92例流产患者为研究对象,其中包括复发性流产患者46例(复发性流产组)和非复发性流产患者46例(非复发性流产组),另选取健康妊娠妇女46例作为对照组。比较3组血清维生素D、sPD-L1及HCG水平;比较治疗前后及不同预后复发性流产患者的血清维生素D、sPD-L1及HCG水平;采用Spearman相关分析血清维生素D、sPD-L1及HCG水平与复发性流产主动免疫治疗预后的相关性。结果复发性流产组治疗前血清维生素D、HCG水平均低于非复发性流产组治疗前与对照组,sPD-L1水平高于非复发性流产组治疗前与对照组,差异均有统计学意义(P<0.05)。与治疗前比较,复发性流产组治疗后血清维生素D及HCG水平均明显升高,sPD-L1水平明显降低,差异均有统计学意义(P<0.05)。复发性流产组患者随访1年后,再次妊娠活产患者血清维生素D及HCG水平均明显高于流产患者,sPD-L1水平明显低于流产患者,差异均有统计学意义(P<0.05)。血清维生素D及HCG水平与复发性流产主动免疫治疗预后呈正相关(P<0.05),sPD-L1水平与复发性流产主动免疫治疗预后呈负相关(P<0.05)。结论血清维生素D、sPD-L1及HCG水平与复发性流产主动免疫治疗预后具有相关性,可作为患者预后评价的重要参考指标。

Objective To study the relationship between serum vitamin D,soluble programmed death molecular ligand 1(sPD-L1)and human chorionic gonadotropin(HCG)levels and the prognosis of active immunotherapy for recurrent abortion.Methods A total of 92 cases of abortion patients admitted to Wuhan Third Hospital from January 2017 to February 2018 were selected as the research objects,including 46 cases of recurrent abortion(recurrent abortion group)and 46 cases of non-recurrent abortion(non-recurrent abortion group),and 46 cases of healthy pregnant women were selected as the control group.The serum levels of vitamin D,sPD-L1 and HCG were compared among the 3 groups.The serum levels of vitamin D,sPD-L1 and HCG in patients with recurrent abortion were compared before and after treatment and with different prognosis.Spearman correlation analysis was used to analyze the correlation between serum vitamin D,sPD-L1,HCG levels and the prognosis of active immunotherapy for recurrent abortion.Results Serum vitamin D and HCG levels in the recurrent abortion group before treatment were lower than those in the non-recurrent abortion group before treatment and the control group,and sPD-L1 level was higher than that in the non-recurrent abortion group before treatment and the control group,the differences were statistically significant(P<0.05).Compared with before treatment,serum vitamin D and HCG levels in the recurrent abortion group were significantly increased after treatment,and sPD-L1 level was significantly reduced after treatment,and the differences were statistically significant(P<0.05).After 1 year of follow-up in the recurrent abortion group,the serum vitamin D and HCG levels in the re-pregnant live birth patients were significantly higher than those in the abortion patients,and the sPD-L1 level was significantly lower than that in the abortion patients,the differences were statistically significant(P<0.05).Serum vitamin D and HCG levels were positively correlated with the prognosis of active immunotherapy for recurrent abortion(P<0.05),and sPD-L1 level was negatively correlated with the prognosis of active immunotherapy for recurrent abortion(P<0.05).Conclusion Serum vitamin D,sPD-L1 and HCG levels are correlated with the prognosis of active immunotherapy for recurrent abortion and can be used as an important reference indicator for prognosis evaluation of patients.