血清TLR2、PGE2、IL-6对自发性早产的预测价值研究

Serum TLR2,PGE2,and IL-6 in prediction of spontaneous preterm birth

目的探讨血清TOLL样受体2(TLR2)、前列腺素E2(PGE2)、白细胞介素-6(IL-6)对自发性早产(SPB)的预测价值。方法收集2019年3月至2020年3月于济南市妇幼保健院产检具有早产高危因素的孕妇289例,其中有21例SPB、263例足月产、3例治疗性早产、1例晚期流产、1例失访,最终纳入284例。研究组21例(SPB),分娩孕周(34.08±2.16)周;对照组263例(足月产),分娩孕周(39.25±1.11)周。比较两组临床资料,行TLR2、PGE2及IL-6检测。计量资料符合正态分布,以均值±标准差(xˉ±s)描述,采用独立样本t检验,计数资料比较采用χ^(2)检验,采用多因素logistic回归模型分析SPB的独立预测因子,应用受试者工作特征曲线(ROC)评估血清TLR2、PGE2及IL-6对SPB的预测价值。结果研究组血清TLR2、PGE2、IL-6水平均高于对照组(t=8.971、5.813、5.228,均P<0.05)。logistic回归分析显示,TLR2、PGE2和IL-6的比值比分别为1.590、1.714、1.501,是SPB的独立预测因子(均P<0.05)。ROC分析显示,TLR2、PGE2和IL-6预测SPB的曲线下面积分别为0.895、0.807和0.900,以IL-6的预测价值最大(灵敏度为90.48%,特异度为77.78%)。结论血清TLR2、PGE2、IL-6均是SPB的独立预测因子,以IL-6的预测价值较高。

Objective To investigate the values of toll-like receptor 2(TLR2),prostaglandin E2(PGE2),and interleukin-6(IL-6)in the prediction of spontaneous preterm birth(SPB).Methods A total of 289 pregnant women with high risk factors of preterm delivery in Jinan Maternal and Child Health Care Hospital from March 2019 to March 2020 were collected,including 21 cases of SPB,263 cases of term birth,3 cases of therapeutic preterm birth,1 case of late abortion,and 1 case of missed follow up;at last,284 cases were included.The study group had 21 cases(SPB),and were(34.08±2.16)weeks pregnant when they delivered.The control group had 263 cases(term birth),and were(39.25±1.11)weeks pregnant when they delivered.The clinical data of the two groups were compared.The levels of TLR2,PGE2,and IL-6 were detected.The measurement data of normal distribution was described as(xˉ±s),and were compared by independent-sample t test.The enumeration data were compared byχ^(2) test.The multivariate logistic regression model was used to analyze the independent predictors of SPB.The values of serum TLR2,PGE2,and IL-6 in the prediction of SPB were assessed by the receiver operating characteristic curve(ROC).Results The serum levels of TLR2,PGE2,and IL-6 in the study group were significantly higher than those in the control group(t=8.971,5.813,and 5.228;all P<0.05).Logistic regression analysis showed that the odds ratios of TLR2,PGE2,and IL-6 were 1.590,1.714,and 1.501,respectively,and were independent predictors of SPB(all P<0.05).The ROC analysis showed that the areas under the curves of TLR2,PGE2,and IL-6 in the prediction of SPB were 0.895,0.807,and 0.900,respectively;the predictive value of IL-6 was the highest,with a sensitivity of 90.48%and a specificity of 77.78%.Conclusion Serum TLR2,PGE2,and IL-6 are independent predictors of SPB,and IL-6 has a higher predictive value.