血清NRP-1、PDGF与子宫内膜异位症患者体外受精-胚胎移植妊娠结局的相关性

Correlation between serum NRP-1,PDGF and in vitro fertilization embryo transfer pregnancy outcomes in patients with endometriosis

目的研究子宫内膜异位症患者血清神经纤毛蛋白-1(NRP-1)、血小板衍生生长因子(PDGF)水平与体外受精-胚胎移植(IVF-ET)妊娠结局的相关性。方法回顾性分析2017年6月至2019年10月廊坊市人民医院收治的接受IVF-ET治疗的子宫内膜异位症患者89例作为观察组,根据对患者随访结果,分为妊娠结局良好组(n=53),妊娠结局不良组(n=36)。另选择在廊坊市人民医院体检健康女性82名为对照组。采用酶联免疫吸附试验(ELISA)测定血清NRP-1、PDGF水平。Pearson法对分析妊娠结局不良患者血清NRP-1、PDGF、雌二醇、促黄体生成素(LH)、基础卵泡刺激素(FSH)的相关性。利用受试者工作特征(ROC)曲线评价血清NRP-1、PDGF水平预测子宫内膜异位症患者IVF-ET妊娠结局的价值。结果观察组的血清NRP-1、PDGF水平分别为(27.81±6.47)μg/L、(31.83±7.58)ng/mL,均高于对照组[(18.06±3.91)μg/L、(21.61±4.62)ng/mL],差异均有统计学意义(P<0.05)。妊娠结局不良组的基础FSH、基础雌二醇、基础LH水平分别为(8.83±1.46)mIU/mL、(85.67±17.09)pg/mL、(8.32±1.35)mIU/mL,均高于妊娠结局良好组[(4.63±0.91)mIU/mL、(50.12±11.31)pg/mL、(3.66±0.91)mIU/mL],血清NRP-1、PDGF水平分别为(22.72±5.28)μg/L、(24.98±5.95)ng/mL,均低于妊娠结局良好组[(31.27±7.27)μg/L、(36.49±8.68)ng/mL],差异均有统计学意义(P<0.05)。观察组血清NRP-1与PDGF表达水平呈正相关(P<0.05);妊娠结局不良患者血清NRP-1、PDGF水平均与基础FSH水平、基础雌二醇水平、基础LH水平均呈负相关(P<0.05)。ROC分析显示,NRP-1联合PDGF预测子宫内膜异位症患者患者IVF-ET妊娠结局的AUC为0.942,其敏感度、特异度分别为80.60%、96.20%。结论妊娠结局良好的子宫内膜异位症患者血清NRP-1和PDGF呈高表达,二者与IVF-ET妊娠结局密切相关,NRP-1和PDGF对子宫内膜异位症患者IVF-ET妊娠结局有一定预测价值。

Objective To study the correlation between serum neuropilin-1(NRP-1)and platelet-derived growth factor(PDGF)levels in patients with endometriosis and the pregnancy outcome of in vitro fertilization-embryo transfer(IVF-ET).Methods A retrospective analysis of 89 cases of endometriosis treated by IVF-ET admitted to Langfang People's Hospital from June 2017 to October 2019 was the observation group,according to the follow-up results of the patients,they were divided into a good pregnancy outcome group(n=53)and a poor pregnancy outcome group(n=36),82 healthy women who underwent physical examination in Langfang People's Hospital were selected as the control group.The levels of serum NRP-1 and PDGF was measured by enzyme-linked immunosorbent assay.The correlation of serum NRP-1,PDGF,estradiol,luteinizing hormone(LH)and follicle stimulating hormone(FSH)of patients with adverse pregnancy outcomes was analyzed by Pearson method.The value of serum NRP-1 and PDGF levels in predicting the pregnancy outcome of IVF-ET in patients with endometriosis was evaluated by receiver operating characteristic(ROC)curve.Results The levels of serum NRP-1 and PDGF in the observation group were(27.81±6.47)μg/L,(31.83±7.58)ng/mL,respectively,which were higher than those in the control group[(18.06±3.91)μg/L,(21.61±4.62)ng/mL],the differences were statistically significant(P<0.05).The levels of basic FSH,basic estradiol,basic LH in the poor pregnancy outcome group were(8.83±1.46)mIU/mL,(85.67±17.09)pg/mL,(8.32±1.35)mIU/mL,which were higher than those in the good pregnancy outcome group[(4.63±0.91)mIU/mL,(50.12±11.31)pg/mL,(3.66±0.91)mIU/mL],the levels of serum NRP-1 and PDGF in the poor pregnancy outcome group were(22.72±5.28)μg/L,(24.98±5.95)ng/mL,which were lower than those in the good pregnancy outcome group[(31.27±7.27)μg/L,(36.49±8.68)ng/mL],the differences were statistically significant(P<0.05).The expression levels of serum NRP-1 and PDGF in patients with endometriosis were positively correlated(P<0.05);serum NRP-1 and PDGF levels were negatively correlated with basal FSH,basal estradiol and basal LH levels in patients with poor pregnancy outcomes(P<0.05).ROC analysis showed that the AUC of NRP-1 combined with PDGF in predicting the pregnancy outcome of IVF-ET in patients with endometriosis was 0.942,and its sensitivity and specificity were 80.60%and 96.20%,respectively.Conclusion Serum NRP-1 and PDGF are highly expressed in endometriosis patients with good pregnancy outcomes,and they are closely related to the outcome of IVF-ET pregnancy,NRP-1 and PDGF have certain predictive value for IVF-ET pregnancy outcomes in patients with endometriosis.