血清MMP-9、TIMP-1水平对早期稽留流产术后宫腔粘连的预测价值

Predictive value of serum MMP-9 and TIMP-1 levels for intrauterine adhesions after early missed abortion

目的探讨血清基质金属蛋白酶-9(MMP-9)、金属蛋白酶组织抑制物-1(TIMP-1)水平对早期稽留流产术后宫腔粘连的预测价值。方法分析2019年10月至2021年7月江苏省连云港市第一人民医院收治的92例早期稽留流产患者的一般资料。统计早期稽留流产患者术后1个月宫腔粘连的发生情况,并依据是否发生宫腔粘连分为发生组和未发生组。分析早期稽留流产术后发生宫腔粘连的危险因素,绘制受试者操作特征曲线,评价血清MMP-9、TIMP-1对早期稽留流产术后宫腔粘连的预测价值。结果早期稽留流产术后1个月宫腔粘连发生率为35.87%。发生组人工流产次数、宫腔操作次数多于未发生组(P<0.05);发生组肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)、IL-35、MMP-9及TIMP-1水平高于未发生组。人工流产次数、宫腔操作次数、血清MMP-9及TIMP-1为早期稽留流产术后发生宫腔粘连的危险因素(OR>1,P<0.05)。血清MMP-9、TIMP-1联合预测早期稽留流产术后宫腔粘连的特异度、曲线下面积高于单独预测(P<0.05)。结论血清MMP-9、TIMP-1水平对早期稽留流产术后宫腔粘连的预测价值较高,可作为临床进行评估的重要参考指标。

Objective To explore the predictive value of serum matrix metalloproteinase-9(MMP-9)and tissue inhibitor of metalloproteinase-1(TIMP-1)levels for intrauterine adhesions after early missed abortion.Methods The general data of 92 patients with early missed abortion admitted to the First People’s Hospital of Lianyungang,Jiangsu Province from October 2019 to July 2021 were analyzed.The incidence of intrauterine adhesions in patients with early missed abortion one month after operation was counted,and according to whether intrauterine adhesions occurred,they were divided into occurrence group and non-occurring group.The risk factors for intrauterine adhesions after early missed abortion were analyzed,the receiver operating characteristic curve was drawn,and the predictive value of serum MMP-9 and TIMP-1 for intrauterine adhesions after early missed abortion was evaluated.Results The incidence of intrauterine adhesions one month after operation was 35.87%.The number of induced abortions,the number of uterine cavity operations in occurrence group were more than those in non-occurring group;tumor necrosis factor-α(TNF-α),interleukin-17(IL-17),IL-35,MMP-9,and TIMP-1 levels in occurrence group were higher than those in non-occurring group(P<0.05).The number of induced abortions,the number of uterine cavity operations,serum MMP-9,and TIMP-1 were risk factors for intrauterine adhesions after early missed abortion(OR>1,P<0.05).The specificity and area under the curve of serum MMP-9 and TIMP-1 in predicting intrauterine adhesions after early missed abortion was higher than predicted alone(P<0.05).Conclusion Serum MMP-9 and TIMP-1 levels have a high predictive value for intrauterine adhesions after early missed abortion,and can be used as important reference indicators for clinical evaluation.