抗核抗体联合T淋巴细胞亚群检测对复发性流产妊娠结局的预测价值

The Predictive Value of Combined Detection of Anti Nuclear Antibodies and T Lymphocyte Subsets for Recurrent Miscarriage Pregnancy Outcomes

目的:探究抗核抗体(ANA)联合T淋巴细胞亚群检测对复发性流产(RSA)妊娠结局的预测价值。方法:选择2020年2月—2022年7月赣州市妇幼保健院收治的50例RSA患者入研究组,另选择50例同期于本院行产前检查的正常妊娠孕妇入对照组。采集所有参检者清晨空腹肘静脉血5 mL,检测ANA、T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD16^(+)CD56^(+))水平,并计算CD4^(+)/CD8^(+)值。结果:研究组29例患者于孕10周前发生流产,流产率为58.00%(29/50);对照组于孕10周前发生流产共13例,流产率为26.00%(13/50),两组流产率对比,差异有统计学意义(χ^(2)=10.509,P=0.001)。相比于对照组,研究组ANA阳性检出率较高,CD4^(+)、CD16^(+)CD56^(+)、CD4^(+)/CD8^(+)水平均较高,CD8^(+)水平较低,差异均有统计学意义(P<0.05)。联合检测在RSA中的预测价值最高,AUC为0.872,敏感度为0.875,特异度为0.393,其次为CD16^(+)CD56^(+)、CD4^(+)、CD4^(+)/CD8^(+)、CD8^(+)、ANA。结论:ANA联合T淋巴细胞亚群检测在RSA诊断中应用价值较高,能够有效预测RSA发生风险,为临床尽早干预提供可靠的参考。

Objective:To explore the predictive value of anti nuclear antibody(ANA)combined with T lymphocyte subpopulations detection in pregnancy outcomes of recurrent spontaneous abortion(RSA).Method:A total of 50 RSA patients admitted to Ganzhou Maternal and Child Health Hospital from February 2020 to July 2022 were selected as the study group,and another 50 normal pregnant women who underwent prenatal examinations in author's hospital during the same period were selected as the control group.5 mL fasting elbow venous blood was collected from all subjects in the morning to detect the levels of ANA and T lymphocyte subpopulations(CD4^(+),CD8^(+),CD16^(+)CD56^(+)),and the CD4^(+)/CD8^(+)ratio was calculated.Result:A total of 29 patients in the study group experienced miscarriage before 10 weeks of pregnancy,with a miscarriage rate of 58.00%(29/50);there were 13 cases of miscarriage in the control group before 10 weeks of pregnancy,with a miscarriage rate of 26.00%(13/50).The difference in miscarriage rates between the two groups was statistically significant(χ^(2)=10.509,P=0.001).Compared with the control group,the positive detection rate of ANA in the study group was higher,with higher levels of CD4^(+),CD16^(+)CD56^(+),CD4^(+)/CD8^(+),and lower levels of CD8^(+),the differences were statistically significant(P<0.05).Joint detection had the highest predictive value in RSA,with an AUC of 0.872,sensitivity of 0.875,specificity of 0.393,followed by CD16^(+)CD56^(+),CD4^(+),CD4^(+)/CD8^(+),CD8^(+),ANA.Conclusion:The application value of ANA combined with T lymphocyte subpopulations has high application value in the diagnosis of RSA,which can effectively predict the risk of RSA occurrence and provide reliable reference for early clinical intervention.