血浆蛋白C、蛋白S、D-二聚体与先兆流产的相关性分析

The Correlation Analysis of Plasma PC,PS,and D-dimer and Threatened Abortion

目的通过分析先兆流产患者血浆蛋白C(PC)、蛋白S(PS)、D-二聚体(D-D)水平的变化,探讨其与先兆流产的相关性及其诊断价值。方法回顾性分析2021年1月至2023年12月于首都医科大学附属北京世纪坛医院就诊的55例先兆流产患者的临床资料,并将其纳入为研究组,另选取49例健康妊娠孕妇纳入为对照组。比较两组孕妇血浆PC、PS、D-D水平;分析先兆流产的影响因素;绘制ROC曲线,分析血浆PC、PS、D-D单独检测及联合检测对先兆流产的诊断效能。结果研究组患者血浆PC、PS水平明显低于对照组,D-D水平高于对照组,差异有统计学意义(P=0.004,P<0.001,P<0.001);血浆PC、PS水平降低,D-D水平升高为先兆流产发生的独立危险因素(P=0.039,P<0.001,P=0.004)。ROC工作曲线分析结果显示,PC、PS、D-D用于预测先兆流产的曲线下面积分别为:0.648、0.788、0.696(P=0.013,P<0.001,P=0.001),联合检测的曲线下面积为0.836(P<0.001)。结论先兆流产患者血浆PC、PS水平减低,D-D水平升高,是先兆流产的独立危险因素,联合检测有助于预测先兆流产的发生。

Objective The objective of the current study was to explore correlation patterns and diagnostic value with threatened abortion by analyzing the changes in plasma protein C(PC),protein S(PS),and D-dimer(D-D)levels in patients with threatened abortion.Methods The clinical data of 55 patients with threatened abortion in Shijitan Hospital from January,2021 to December,2023 were retrospectively analyzed.These subjects were included in the study group,while 49 healthy pregnant women were included in the control group.The plasma levels of PC,PS,and D-D were compared between the two groups.The influencing factors of threatened abortion were identified.ROC curves were drawn to evaluate the diagnostic efficacy of plasma PC,PS,D-D alone,and combined tests for threatened abortion.Results The plasma levels of PC and PS in the study group were significantly lower than those in the control group,while the levels of D-D were higher than those in the control group(P=0.004,P<0.001,P<0.001).The decrease in plasma PC and PS levels and the increase in D-D levels were independent risk factors for threatened abortion(P=0.039,P<0.001,P=0.004).The receiver operator characteristic(ROC)curve analysis showed that the area under the curve(AUC)for PC,PS and D-D in predicting threatened abortion were 0.648,0.788 and 0.696(P=0.013,P<0.001,P=0.001),respectively,while the AUC of the combined tests was 0.836(P<0.001).Conclusion Plasma PC and PS levels decrease and D-D levels increase in patients with threatened abortion,which could be independent risk factors for threatened abortion.Combined tests of these markers can help predict the occurrence of threatened abortion.