外周血巨噬细胞移动抑制因子、人类白细胞DR抗原表达对自身免疫性卵巢早衰的诊断价值

Diagnostic value of macrophage migration inhibitory factor, human leukocyte DR antigen expression in peripheral blood for autoimmune premature ovarian failure

目的探讨外周血巨噬细胞移动抑制因子(MIF)、人类白细胞DR抗原(HLA-DR)诊断自身免疫性卵巢早衰(APOF)的价值。方法选择2018年6月至2020年6月成都市新都区中医医院(以下简称“我院”)收治124例POF患者。根据APOF诊断标准将患者分为APOF组(45例),NAPOF组(79例),另选择同期我院妇产科门诊体检的60名健康女性为对照组。检测外周血MIF、HLA-DR+CD3+、HLA-DR+CD19+、抗卵巢抗体(AOAb)、抗透明带抗体(AZpAb)、抗核抗体(ANA)表达。分析上述指标与APOF发病的关系以及诊断APOF的价值。结果APOF组AOAb、AZpAb、ANA阳性占比及MIF、HLA-DR+CD3+、HLA-DR+CD19+水平高于NAPOF组和对照组(P<0.05);NAPOF组MIF、HLA-DR+CD3+、HLA-DR+CD19+水平高于对照组(P<0.05)。合并自身免疫性疾病、AOAb阳性、AZpAb阳性、ANA阳性APOF患者MIF、HLA-DR+CD3+、HLA-DR+CD19+水平高于未合并自身免疫性疾病、AOAb阴性、AZpAb阴性、ANA阴性患者(P<0.05)。合并自身免疫性疾病,高MIF、HLA-DR+CD3+、HLA-DR+CD19+水平是APOF发病的危险因素(OR>1,P<0.05)。MIF、HLA-DR+CD3+、HLA-DR+CD19+、联合MIF和HLA-DR+CD3+、HLA-DR+CD19+诊断APOF的曲线下面积分别为0.717、0.736、0.705、0.934。结论APOF患者外周血MIF、HLA-DR+CD3+、HLA-DR+CD19+水平升高,高MIF、HLA-DR+CD3+、HLA-DR+CD19+水平与APOF发病密切相关,可为APOF诊断提供参考。

Objective To investigate the value of peripheral blood macrophage migration inhibitory factor(MIF)and human leukocyte antigen DR(HLA-DR)in the diagnosis of autoimmune premature ovarian failure(APOF).Methods A total of 124 patients with POF admitted to Chengdu Xindu District Hospital of Traditional Chinese Medicine(hereinafter referred to as“our hospital”)from June 2018 to June 2020 were selected.According to the APOF diagnostic criteria,the patients were divided into APOF group(45 cases)and NAPOF group(79 cases),and 60 healthy women who underwent physical examination in the Department of Obstetrics and Gynecology of our hospital during the same period were selected as control group.The expression of MIF,HLA-DR+CD3+,HLA-DR+CD19+,anti ovarian antibodies(AOAb),anti-zona pellucida antibodies(AZpAb),and antinuclear antibody(ANA)in peripheral blood were detected.The relationship between the above indicators and the incidence of APOF and the diagnostic value of APOF were analyzed.Results The positive proportion of AOAb,AZpAb,ANA and MIF,HLA-DR+CD3+,and HLA-DR+CD19+levels in APOF group were higher than those in NAPOF group and control group(P<0.05);and MIF,HLA-DR+CD3+,and HLA-DR+CD19+levels in NAPOF group were higher than those in control group(P<0.05).MIF,HLA-DR+CD3+,and HLA-DR+CD19+levels in APOF patients with autoimmune disease,positive AOAb,positive AzpAb,and positive ANA were higher than those patients with no autoimmune disease,negative AOAb,negative AZpAb and negative ANA(P<0.05).Autoimmune diseases,high MIF,HLA-DR+CD3+,and HLA-DR+CD19+levels were risk factors for APOF(OR>1,P<0.05).The areas under the curve of MIF,HLA-DR+CD3+,HLA-DR+CD19+,and combined MIF and HLA-DR+CD3+,HLA-DR+CD19+were 0.717,0.736,0.705,0.934,respectively.Conclusion MIF,HLA-DR+CD3+,and HLA-DR+CD19+levels in peripheral blood of APOF patients are increased,and the high levels of MIF,HLA-DR+CD3+,and HLA-DR+CD19+are closely related to the pathogenesis of APOF,which can provide a reference for the diagnosis of APOF.