sHLA-G、EmAb对晚期先兆流产患者妊娠结局的预测价值

Predictive value of sHLA-G and EmAb on pregnancy outcome in patients with late threatened abortion

目的探索可溶性人白细胞抗原-G(sHLA-G)、抗子宫内膜抗体(EmAb)对晚期先兆流产患者妊娠结局的预测价值。方法选取2019年6月至2021年11月收治的120例晚期先兆流产患者为先兆流产组,再纳入同期进行检查的50例正常妊娠孕妇为对照组。采用酶联免疫吸附法检测两组的sHLA-G、EmAb水平。根据妊娠结局将120例晚期先兆流产患者分为妊娠失败组与分娩组,采用单因素及Logistic多元回归分析影响患者妊娠结局的因素,使用受试者工作特征(ROC)曲线分析sHLA-G、EmAb以及两者联合对晚期先兆流产的诊断价值。结果先兆流产组的sHLA-G水平低于对照组,EmAb光密度(OD)值高于对照组(P<0.05)。妊娠失败组的年龄大于分娩组,既往自然流产史、贫血、初产妇、吸烟、酗酒、合并阴道炎、子宫缺陷、阴道大量出血、宫内大血肿、污染接触职业的占比以及EmAb OD值高于分娩组,sHLA-G水平低于分娩组(P<0.05)。Logistic回归分析结果显示,年龄、合并阴道炎、子宫缺陷、污染接触职业、sHLA-G以及EmAb均是晚期先兆流产患者妊娠结局的影响因素(P<0.05)。ROC曲线分析显示,sHLA-G、EmAb联合诊断晚期先兆流产的灵敏度、特异度、约登指数以及ROC曲线下面积(AUC)最高。结论sHLA-G、EmAb可作为晚期先兆流产患者妊娠结局的预测指标,两者联合可提高诊断价值。

Objective To explore the predictive value of soluble human leukocyte antigen-G(sHLA-G)and anti-endometrial antibody(EmAb)on pregnancy outcome in patients with late threatened abortion.Methods A total of 120 patients with late threatened abortion admitted from June 2019 to November 2021 were selected as threatened abortion group,and 50 normal pregnant women who were examined during the same period were included as control group.The levels of sHLA-G and EmAb of the two groups were detected by enzyme-linked immunosorbent assay.According to the pregnancy outcome,120 patients with late threatened abortion were divided into pregnancy failure group and delivery group.Single factor and Logistic multiple regression were used to analyze the factors affecting the pregnancy outcome of patients.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of sHLA-G,EmAb and their combination for late threatened abortion.Results The level of sHLA-G in the threatened abortion group was lower than that in the control group,and the EmAb optical density(OD)value was higher than that in the control group(P<0.05).The age of the pregnancy failure group was greater than that of the delivery group,the proportions of previous spontaneous abortion history,anemia,primipara,smoking,alcoholism,combined with vaginitis,uterine defects,massive vaginal bleeding,intrauterine hematoma,pollution exposure occupation and EmAb OD value were higher than those of the delivery group,and the level of sHLA-G was lower than that of the delivery group(P<0.05).Logistic regression analysis results showed that age,combined with vaginitis,uterine defects,pollution exposure occupation,sHLA-G and EmAb were all influencing factors for pregnancy in patients with late threatened abortion(P<0.05).ROC curve analysis showed that the combination of sHLA-G and EmAb had the highest sensitivity,specificity,Youden index and area under the ROC curve(AUC)in the diagnosis of late threatened abortion.Conclusion The sHLA-G and EmAb can be used as predictors of pregnancy outcome in patients with late threatened abortion,and the combination of the two can improve the diagnostic value.