PAI-1、Hcy水平与妊娠合并心脏病患者妊娠结局的相关性分析

A Correlation Analysis Between PAI-1 and Hcy Levels and Pregnancy Outcomes in Pregnant Women with Heart Disease

目的探讨纤溶酶原激活物抑制物-1(PAI-1)、同型半胱氨酸(Hcy)水平与妊娠合并心脏病患者妊娠结局的相关性。方法选取2020年1月至2023年1月我院收治的80例合并心脏病的孕妇作为研究组,另选取同期产检健康孕妇80例作为对照组,比较研究组与对照组PAI-1、Hcy水平。将研究组患者根据妊娠结局分为妊娠不良组22例和妊娠良好组58例,比较两组临床资料、三酰甘油(TG)、总胆固醇(TC)、PAI-1、Hcy水平;相关性采用Spearman秩相关分析检验;多因素分析采取二元Logistics回归分析;绘制ROC曲线,分析血清PAI-1、Hcy水平预测不良妊娠结局的价值。结果研究组PAI-1、Hcy水平显著高于对照组(P<0.05);妊娠不良组和妊娠良好组年龄、产次、孕周、分娩孕周、心脏病类型、心功能分级、TC、TG比较差异无统计学意义(P>0.05),妊娠不良组PAI-1、Hcy水平显著高于妊娠良好组(P<0.05);妊娠合并心脏病患者血清PAI-1、Hcy水平与不良妊娠结局呈正相关(P<0.05);多因素Logistic回归分析显示,PAI-1及Hcy为妊娠合并心脏病患者不良妊娠结局的显著影响因素;经ROC分析发现PAI-1、Hcy水平可用于妊娠合并心脏病患者不良妊娠结局的预测,曲线下面积为0.810、0.817,联合预测曲线下面积为0.918。结论妊娠合并心脏病患者血清PAI-1、Hcy水平显著增加孕妇不良妊娠结局发生率,上述指标与不良妊娠结局显著相关,其水平是不良妊娠结局的影响因素,并可用于不良妊娠结局预测,联合预测价值更高。

Objective To explore the correlation between levels of plasminogen activator inhibitor-1(PAI-1)and homocysteine(Hcy)and the pregnancy outcomes of pregnant women with heart disease.Methods 80 pregnant women with heart disease admitted to our hospital from January,2020 to January,2023 were selected as the study group,while 80 healthy pregnant women were selected as the control group.Levels of PAI-1 and Hcy between these two group were compared.Patients in the study group were further divided into a poor pregnancy group(22 cases)and a good pregnancy group(58 cases)according to the pregnancy outcome.The clinical data,triglyceride(TG),total cholesterol(TC),PAI-1 and Hcy levels of the two groups were compared.The correlation was tested by Spearman rank correlation analysis.Multivariate analysis was conducted by binary logistics regression method;ROC curve was drawn to evaluate the value of serum PAI-1 and Hcy levels in predicting adverse pregnancy outcomes.Results Levels of PAI-1 and Hcy in the study group were significantly higher than those in the control group(P<0.05).There was no significant difference in age,parity,gestational age,delivery gestational age,heart disease type,cardiac function classification,TC and TG between the poor pregnancy group and the good pregnancy group(P>0.05).Levels of PAI-1 and Hcy in the poor pregnancy group were significantly higher than those in the good pregnancy group(P<0.05).Levels of serum PAI-1 and Hcy in pregnant women with heart disease were positively correlated with the adverse pregnancy outcome(P<0.05).Multivariate logistic regression analysis showed that PAI-1 and Hcy were significant influencing factors of adverse pregnancy outcome in pregnant women with heart disease.ROC curve showed that levels of PAI-1 and Hcy were able to predict the adverse pregnancy outcome of patients with pregnancy complicated with heart disease.The area under the curve were 0.810 and 0.817,respectively,while the area under the joint prediction curve was 0.918.Conclusion Levels of serum PAI-1 and Hcy in pregnant women with heart disease significantly increase the incidence of adverse pregnancy outcomes.These indexes are significantly related to adverse pregnancy outcomes,and their levels are the influencing factors,which can be used to predict adverse pregnancy outcomes,and the joint prediction value is higher than single-marker prediction.