EmAb、ACA及PDW联合检测在复发性流产临床诊断中的应用价值

Application value of combined detection of EmAb,ACA and PDW in clinical diagnosis of recurrent miscarriage

目的探讨抗子宫内膜抗体(EmAb)、抗心磷脂抗体(ACA)及血小板分布宽度(PDW联合检测在复发性流产临床诊断中的应用价值。方法对2018年7月-2020年6月本院收治的106例复发性流产的产妇的临床治疗进行整理,设为观察组;选取同期在本院进行孕检的106例健康女性设为对照组。比较2组EmAb、ACA及PDW表达情况,并比较不同流产次数的产妇血清mAb、ACA及PDW水平。比较不同人群EmAb、ACA及PDW表达情况,绘制ROC曲线分析EmAb、ACA及PDW检测及三者联合检测对妊娠期妇女发生复发性流产的预测价值。结果观察组EmAb及ACA阳性表达率明显高于对照组,PDW表达水平显著高于对照组,差异均具有统计学意义(P<0.05)。EmAb、ACA阳性表达率:流产4次>流产3次>流产2次,PDW表达水平:流产4次>流产3次>流产2次,差异均具有统计学意义(P<0.05)。ROC曲线分析结果显示,EmAb、ACA、PDW单独及三者联合检测曲线下面积分别为0.878、0.834、0.855、0.945,各指标曲线下面积以联合检测最大(P<0.005)。结论血清AcA、EMAb、PDW水平检测对孕早期复发性流产的诊断具有重要临床意义,三者可作为预测复发性流产的敏感性指标。

Objective To explore the application value of combined detection of anti-endometrial antibody(EmAb),anticardiolipin antibody(ACA)and platelet distribution width(PDW)in the clinical diagnosis of recurrent abortion. Method The clinical data of 106 women with recurrent miscarriage admitted to this hospital from July 2018 to June 2020 were sorted out and set as the observation group. 106 healthy women with pregnancy examination in this hospital during the same period who were selected were set as the control group. The expressions of Emab,ACA,and PDW in the two groups were measured and compared,and the serum mAb,ACA,and PDW levels of women with different number of abortions were compared. The levels of serum Emab,ACA and PDW in different people were compared,and the ROC curve was drawn to analyze the predictive value of Emab,ACA and PDW detection and the combined detection of the three for the diagnosis of recurrent miscarriage in pregnant women. Result The positive expression rates of Emab and ACA in the observation group were significantly higher than those in the control group. The PDW level in the observation group was significantly higher than that in the control group. The difference of serum Emab,ACA and PDW levels between the two groups was statistically significant(P<0.05). The positive expression rates of Emab and ACA in patients with 4 abortions were significantly higher than those in the control group,and the level of PDW was significantly higher than that in the control group. There were statistically significant differences of the levels of serum Emab,ACA and PDW between the two groups(P<0.05). The ROC curve analysis results show that the area under the curve of Emab,ACA,PDW alone and the three combined detection curves are 0.878,0.834,0.855,0.945,respectively. The area under the curve of the three combined detection was the largest(P<0.005). Conclusion The higher the number of recurrent miscarriages is,the higher the serum Ac A,EMAb,and PDW levels of pregnant women are. The detection of serum Ac A,EMAb and PDW levels has important clinical significance in the diagnosis of recurrent miscarriage in the first trimester,and the three can be used as sensitive indicators for predicting recurrent miscarriage.