复发性流产患者血浆低氧诱导因子-1α、淀粉样蛋白A、蛋白S活性水平变化及预测价值

Changes of Plasma Hypoxia-inducible factor-1α,Amyloid A and Protein S Activity Levels in Patients with Recurrent Miscarriage and their Predictive Value

目的:探讨复发性流产(RSA)患者血浆低氧诱导因子-1α(HIF-1α)、淀粉样蛋白A(SAA)、蛋白S活性水平变化及预测价值.方法:选择2020年6月至2022年6月在本院进行产前检查的93例RSA患者(自然流产次数≥2次)为RSA组,选择同期既往无自然流产史健康早孕产检孕妇93例为对照组.比较两组血浆HIF-1α、SAA、蛋白S活性水平,分析血浆IF-1α、SAA、蛋白S活性水平临床意义,以及三者联合诊断RSA的临床价值.结果:与对照组相比,RSA组血浆HIF-1α、SAA水平较高,蛋白S活性水平较低,差异有统计学意义(P<0.05).受试者工作特征(ROC)曲线分析显示,血浆HIF-1α、SAA、蛋白S活性水平联合预测RSA的ROC曲线下面积(AUC)最大(AUC=0.893),且敏感度(84.95%)、特异度(94.62%)最高,差异有统计学意义(P<0.05).结论:血浆HIF-1α、SAA水平在RSA患者中呈高表达,蛋白S活性呈低表达,联合应用时可有效预测RSA发生,为临床早期预防提供依据.

Objective:To investigate the changes and predictive value of plasma hypoxia-inducible factor-lα(HIF-lα),amyloid A(SAA)and protein S activity levels in patients with recurrent miscarriage(RSA).Methods:Ninety-three patients with RSA(spontaneous abortion≥2 twice)who underwent obstetric examination from June 2020 to June 2022 in our hospital were selected as the RSA group,and 93 pregnant women with healthy early pregnancy obstetric examination without a history of previous abortion during the same period were selected as the control group.The plasma HIF-1α,SAA and protein S activity levels were compared between the two groups,and predictive value for the development of RSA were analyzed.Results:Compared with the control group,plasma HIF-1αand SAA levels were higher and protein S activity levels were lower in the RSA group(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of combined plasma HIF-lα,SAA,and protein S activity levels had the largest AUC(AUC=0.893)and the highest sensitivity(84.95%)and specificity(94.62%)for predicting RSA(P<0.05).Conclusion:Plasma HIF-1αand SAA levels were highly expressed and protein S activity was low in RSA patients,and the combination was effective in predicting RSA occurrence and providing a basis for early clinical prevention.