冻胚移植后D-二聚体水平、孕激素与雌二醇比值对妊娠结局的影响

Effect of D-dimer and progesterone to estradiol ratio on pregnancy outcome after frozen embryo transfer

目的探究冻胚移植(FET)后患者血清D-二聚体(D-D)、孕激素与雌二醇比值(P/E_(2))对妊娠结局的影响。方法选取邯郸市中心医院2018年6月至2020年6月收治的103例不孕患者作为研究对象,均接受FET治疗,根据妊娠结局分为妊娠组(n=68)与未妊娠组(n=35)。比较两组移植日、移植后3d、7d血清D-D、P/E_(2)水平,分析血清D-D与P/E_(2)的相关性,采用Logistic回归分析血清D-D、P/E_(2)对妊娠结局的影响及其预测妊娠结局的价值。结果未妊娠组移植后3d、7d血清D-D、P/E_(2)水平高于妊娠组(P<0.05)。移植后3d、7d血清D-D与同一时间点P/E_(2)水平呈正相关(P<0.05)。移植后7d血清D-D、P/E_(2)预测妊娠结局的曲线下面积(AUC)分别为0.831、0.856,大于移植后3d血清D-D、P/E_(2)的AUC(0.739、0.828);移植后3d、7d血清D-D、P/E_(2)联合预测妊娠结局的AUC分别为0.844、0.912。结论FET后患者血清D-D与P/E_(2)呈显著正相关,动态监测FET后患者血清D-D、P/E_(2)水平变化可作为预测妊娠结局的潜在途径。

Objective To explore the effects of serum D-dimer(D-D)and progesterone to estradiol ratio(P/E_(2)) on pregnancy outcomes in patients after frozen embryo transfer(FET).Methods 103 infertility patients admitted to Handan Central Hospital from June 2018 to June 2020 were selected as study subjects,all of whom received FET treatment and were divided into pregnancy group(n=68)and non-pregnancy group(n=35)according to pregnancy outcome.Serum D-D and P/E_(2) levels on the day of transplantation,3d and 7d after transplantation were compared between the two groups,and the correlation between serum D-D and P/E_(2) was analyzed,and the effect of serum D-D and P/E_(2) on pregnancy outcome and their value in predicting pregnancy outcome were analyzed by Logistic regression.Results The levels of serum D-D and P/E_(2) in the non-pregnant group at 3d and 7d after transplantation were higher than those in the pregnant group(P<0.05);the serum D-D at 3d and 7d after transplantation was positively correlated with the level of P/E_(2)at the same time point(P<0.05).The areas under the curve(AUC)of serum D-D and P/E_(2)at 7d for predicting pregnancy outcome were 0.831 and 0.856,respectively,which were greater than the AUCs of serum D-D and P/E_(2)at 3d.after transplantation(0.739,0.828).The AUC of 3d and 7d serum D-D and P/E_(2) combined to predict pregnancy outcome were 0.844 and 0.912,respectively.Conclusions There was a signifcant positive correlation between serum D-D and P/E_(2) in patients after FET.Dynamic monitoring of changes in serum D-D and P/E_(2) levels in patients after FET could be a potential way to predict pregnancy outcome.