甲状腺过氧化物酶抗体、抗子宫内膜抗体与先兆流产的关系研究

Study on the relationship between thyroid peroxidase antibody,anti-endometrial antibody and threatened abortion

目的分析甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、抗子宫内膜抗体(antiendometrial antibody,AEMAb)与先兆流产的关系。方法 选择2020年1月至2022年7月西北大学第一医院收治的92例先兆流产孕妇作为观察组,另选同期的92例正常妊娠孕妇作为对照组。检测两组血清TPOAb、AEMAb表达水平,使用多因素Logistic回归分析TPOAb、AEMAb与先兆流产的关系,使用受试者工作特征曲线(receiver operating characteristic,ROC)分析TPOAb联合AEMAb对先兆流产的预测效能,比较观察组继续妊娠孕妇治疗前后的血清TPOAb、AEMAb表达水平。结果 观察组血清TPOAb、AEMAb表达水平均高于对照组,差异有统计学意义(P<0.05);经多因素Logistic回归分析,TPOAb、AEMAb和孕酮均是先兆流产的独立预测因素(P<0.05);经ROC曲线分析,血清TPOAb联合AEMAb预测先兆流产的AUC为0.896,大于孕酮的0.780;观察组继续妊娠孕妇治疗后的血清TPOAb、AEMAb表达水平均较治疗前降低,差异有统计学意义(P<0.05)。结论 TPOAb和AEMAb均可能是导致先兆流产发生的危险因素,联合检测可提高对先兆流产的预测水平,值得临床予以重视应用。

Objective To analyze the relationship between thyroid peroxidase antibody(TPOAb),anti-endometrial antibody(AEMAb) and threatened abortion.Methods 92 pregnant women with threatened abortion admitted to The Fourth People's Hospital of Shaanxi Hospital from January 2020 to July 2022 were selected as the observation group,and 92 pregnant women with normal pregnancy during the same period were selected as the control group.The expression levels of serum TPOAb and AEMAb in the two groups were detected,and the relationship between TPOAb and AEMAb and threatened abortion was analyzed by multivariate logistic regression,and the predictive efficacy of TPOAb combined with AEMAb for threatened abortion was analyzed by receiver operating characteristic curve(ROC).The expression levels of serum TPOAb and AEMAb in the observation group were compared before and after treatment.Results The expression levels of serum TPOAb and AEMAb in the observation group were higher than those in the control group,and the difference was significant(P<0.05).Multivariate Logistic regression analysis showed that TPOAb,AEMAb and progesterone were independent predictors of threatened abortion(P<0.05).According to ROC curve analysis,the AUC of serum TPOAb combined with AEMAb in predicting threatened abortion was 0.896,which was higher than 0.780 of progesterone.The expression levels of serum TPOAb and AEMAb in the observation group after treatment were significantly lower than those before treatment(P<0.05).Conclusion Both TPOAb and AEMAb may be risk factors for threatened abortion,combined detection can improve the prediction level of threatened abortion and is worthy of clinical application.