甲状腺超声联合血清CXCL16对子痫前期合并甲状腺功能减退患者妊娠结局的预测价值

Predictive value of thyroid ultrasound combined with serum CXCL16 onpregnancy outcome in patients with preeclampsia and hypothyroidism

目的观察甲状腺超声联合血清CXC趋化因子配体16(CXCL16)对子痫前期合并甲状腺功能减退患者妊娠结局的预测价值。方法选取2019年1月—2021年1月天津市北辰医院收治的子痫前期合并甲状腺功能减退患者115例,设置为疾病组。另选取同期于该院进行产检的健康孕妇115例,设置为健康组。比较健康组、疾病组甲状腺超声诊断结果以及血清CXCL16水平;随访至疾病组患者分娩,根据妊娠结局随访结果将患者分为不良组、良好组;比较良好组、不良组甲状腺超声诊断结果以及血清CXCL16水平;绘制受试者工作特征曲线(ROC)评价收缩期峰值血流速度(PSV)联合血清CXCL16对妊娠结局的预测价值。结果与健康组比较,疾病组PSV加快(P<0.05),血清CXCL16水平升高(P<0.05)。随访至疾病组患者分娩,不良妊娠结局52例,占比45.22%。将52例患者设置为不良组,其余63例患者设置为良好组。与良好组比较,不良组PSV加快(P<0.05),血清CXCL16水平升高(P<0.05)。ROC曲线结果显示,PSV、CXCL16预测不良妊娠结局的最佳截断点分别为30.72 cm/s、1.62 pg/ml,两者单独及联合预测的AUC分别为0.781、0.819、0.871。两者联合对不良妊娠结局的预测价值高于单独检测。结论甲状腺超声联合血清CXCL16在预测子痫前期合并甲状腺功能减退患者妊娠结局中具有较高效能。

Objective To observe the predictive value of thyroid ultrasound combined with serum CXC chemokine ligand 16(CXCL16)on the pregnancy outcome of patients with preeclampsia and hypothyroidism.Methods A total of 115 patients with preeclampsia and hypothyroidism who were admitted to our hospital from January 2019 to January 2021 were selected as the disease group.In addition,115 healthy pregnant women who underwent check-ups with our hospital during the same period were selected as the healthy group.The thyroid ultrasound diagnosis results and serum CXCL16 levels in the two groups were compared.Follow-up to the delivery of patients in the disease group,and divide the patients into a bad group and a good group according to the follow-up results of pregnancy outcome.The thyroid ultra-sound diagnosis results and serum CXCL16 levels in the good group and the bad group were compared.The receiver operating characteristic curve(ROC)was drawed to evaluate the predictive value of peak systolic blood flow velocity(PSV)combined with serum CXCL16 on preg-nancy outcome.Results Compared with the healthy group,PSV in the disease group was accelerated(P<0.05),of which the serum CX-CL16 level was increased(P<0.05).Follow-up to the delivery of patients in the disease group,52 cases of adverse pregnancy outcomes,accounting for 45.22%.52 patients were set as bad group,and the remaining 63 patients were set as good group.Compared with the good group,PSV in the bad group was accelerated(P<0.05),of which the serum CXCL16 level was increased(P<0.05).ROC curve results showed that the best cut-off points of PSV and CXCL16 for predicting adverse pregnancy outcomes were 30.72 cm/s and 1.62 pg/ml,re-spectively,and the AUC predicted by the two alone and in combination were 0.781,0.819,0.871,respectively.The predictive value of the combination of the two for adverse pregnancy outcome is higher than that of testing alone.Conclusion Thyroid ultrasound combined with serum CXCL16 has a high efficiency in predicting pregnancy outcome in patients with preeclampsia and hypothyroidism.