血清HIF-1α、β-HCG及尿8-OHdG水平对孕早期妊娠丢失的预测价值

Predictive value of levels of serum HIF-1α,β-HCG and urinary 8-OHdG on pregnancy loss in the first trimester

目的研究血清缺氧诱导因子-1α(HIF-1α)、β-人绒毛膜促性腺激素(β-HCG)及尿8-羟基脱氧鸟苷酸(8-OHdG)水平对孕早期妊娠丢失的预测价值。方法回顾性抽取2020年1月至2022年6月于新乡医学院第一附属医院就诊的78例早孕者(孕4~6周)作为研究对象,取其血、尿标本,检测血清HIF-1α、β-HCG与尿8-OHdG水平。对研究对象进行妊娠结局随访;将确诊为妊娠丢失的12例作为研究组,其余66例正常妊娠者作为对照组。比较两组血清HIF-1α、β-HCG与尿8-OHdG水平,采用受试者工作特征曲线分析HIF-1α、β-HCG、8-OHdG对妊娠丢失的预测价值。结果研究组血清HIF-1α、β-HCG水平低于对照组,尿8-OHdG水平高于对照组(P<0.05)。受试者工作特征曲线结果显示,血清HIF-1α、β-HCG及尿8-OHdG水平对孕早期妊娠丢失预测的曲线下面积(AUC)为0.743、0.667、0.709,截断值分别为6295.62 pg/mL、14238.15 IU/L、17.19 ng/mgCr,三者联合的AUC为0.835,灵敏度、特异度均高于单独检测。结论血清HIF-1α、β-HCG在孕早期妊娠丢失患者中表达下降,尿8-OHdG水平上升,三者联合检测对孕早期妊娠丢失具有一定预测价值。

Objective To investigate the predictive value of levels of serum hypoxia inducible factor-1α(HIF-1α),β-human chorionic gonadotropin(β-HCG)and urinary 8-hydroxydeoxyguanylic acid(8-OHdG)on pregnancy loss in the first trimester.Methods A total of 78 women with early pregnancy(at 4-6 weeks of gestation)treated in the First Affiliated Hospital of Xinxiang Medical University from January 2020 to June 2022 were retrospectively selected as the research objects;their blood and urine samples were taken to detect levels of serum HIF-1α,β-HCG and urinary 8-OHdG.The pregnancy outcome was followed up.After then,12 patients diagnosed with pregnancy loss were taken as the study group,and 66 patients with normal pregnancy as the control group.The levels of serum HIF-1α,β-HCG and urinary 8-OHdG were compared between the two groups.The influencing factors of pregnancy loss in the first trimester were analyzed by logistic regression analysis;the predictive value of HIF-1α,β-HCG and 8-OHdG on pregnancy loss was analyzed by receiver operating characteristic curve.Results The levels of serum HIF-1αandβ-HCG in the study group were lower than those in the control group,and the level of urinary 8-OHdG in the study group was higher than that in the control group(P<0.05).Receiver operating characteristic curve showed that the area under the curve(AUC)of the levels of serum HIF-1α,β-HCG and urinary 8-OHdG for predicting pregnancy loss in the first trimester were 0.743,0.667,and 0.709,respectively,and the cut-off values were 6295.62 pg/mL,14238.15 IU/L,17.19 ng/mgCr,respectively.The AUC of the combination of HIF-1α,β-HCG and 8-OHdG was 0.835,and the sensitivity and specificity were higher than those of the three single indicator testings.Conclusions Serum levels of the HIF-1αandβ-HCG decrease in women with pregnancy loss in the first trimester,and the urinary 8-OHdG level increases,which has certain value for pregnancy loss prediction in the first trimester.