[1]段宁娟a,刘 燕,王振威b.先兆流产保胎治疗孕妇血清PCSK9和CTRP6水平对妊娠结局的预测价值研究[J].现代检验医学杂志,2024,39(01):106-111.[doi:10.3969/j.issn.1671-7414.2024.01.019]
　DUAN Ningjuana,LIU Yan,WANG Zhenweib.Predictive Value of Serum PCSK9 and CTRP6 in Pregnant Women Undergoing Threatened Abortion and Fetal Protection Treatment on Pregnancy Outcomes[J].Journal of Modern Laboratory Medicine,2024,39(01):106-111.[doi:10.3969/j.issn.1671-7414.2024.01.019]
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先兆流产保胎治疗孕妇血清PCSK9和CTRP6水平对妊娠结局的预测价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年01期
页码:
106-111
栏目:
论著
出版日期:
2024-01-15

文章信息/Info

Title:
Predictive Value of Serum PCSK9 and CTRP6 in Pregnant Women Undergoing Threatened Abortion and Fetal Protection Treatment on Pregnancy Outcomes
文章编号:
1671-7414（2024）01-106-06
作者:
段宁娟1a; 刘 燕2; 王振威1b
（1. 陕西中医药大学第二附属医院 a. 产科；b. 妇科，陕西咸阳 712000；2. 西安医学院第一附属医院妇科，西安 710077）
Author(s):
DUAN Ningjuan1a;  LIU Yan2;  WANG Zhenwei1b
（1a. Department of Obstetrics；1b. Department of Gynaecology, the Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Shaanxi Xianyang 712000, China；2. Department of Gynaecology, the First Affiliated Hospital of Xi’an Medical University, Xi’an 710077, China）
关键词:
前蛋白转化酶枯草溶菌素9; C1q 肿瘤坏死因子相关蛋白6; 先兆流产; 妊娠结局
分类号:
R714.21；R392.11
DOI:
10.3969/j.issn.1671-7414.2024.01.019
文献标志码:
A
摘要:
目的　探究先兆流产保胎治疗孕妇血清前蛋白转化酶枯草溶菌素9（proprotein convertase subtilisin/kexin type 9，PCSK9），C1q 肿瘤坏死因子相关蛋白6（complement-C1q/tumor necrosis factor-related protein 6，CTRP6）水平对妊娠结局的预测价值。方法　选取2021 年08 月～ 2022 年05 月在陕西中医药大学第二附属医院行保胎治疗的80 例先兆流产孕妇为研究对象，根据妊娠结局将其分为良好妊娠结局组（n=62）、不良妊娠结局组（n=18）；另选取同期在该院孕检正常的孕妇60 例作为对照组。采用酶联免疫吸附法（ELISA）检测研究对象血清PCSK9，CTRP6，孕酮和β- 人绒毛膜促性腺激素（β-HCG）水平；采用Pearson 法分析血清PCSK9，CTRP6 水平与孕酮，β-HCG 水平的相关性；采用多因素Logistic 回归分析影响先兆流产保胎治疗孕妇妊娠结局的因素；采用受试者工作特征（ROC）曲线分析先兆流产保胎治疗孕妇血清PCSK9 和CTRP6 对妊娠结局的预测价值。结果　对照组、良好妊娠结局组和不良妊娠结局组的孕酮（45.65 ± 3.48，38.29 ± 3.54 和31.56 ± 4.11 nmol/L），β-HCG（32 056.56 ± 4 244.54，23 642.32 ± 3 897.67 和11375.56 ± 3 454.35 mIU/L），CTRP6（436.53 ± 36.23，328.44 ± 31.06 和277.86 ± 25.56 ng/ml）水平均呈逐渐降低趋势，PCSK9（64.22 ± 10.35，82.24 ± 13.33 和114.56 ± 17.67 ng/ml）表达水平呈逐渐升高趋势，差异具有统计学意义（F=129.231，199.334，244.007，111.297，均P<0.05）。Pearson 法分析显示，血清PCSK9 与孕酮、β-HCG 水平呈负相关（r=-0.545，-0.514，均P<0.05），血清CTRP6 与孕酮、β-HCG 水平呈正相关（r=0.567，0.496，均P<0.05）。多因素Logistic 回归分析显示，PCSK9 水平升高为先兆流产保胎治疗孕妇妊娠结局的独立危险因素，CTRP6，孕酮、β-HCG 水平升高为先兆流产保胎治疗孕妇妊娠结局的独立保护因素（P<0.05）。ROC 结果显示，先兆流产保胎治疗孕妇血清PCSK9，CTRP6 预测患者发生不良妊娠结局的曲线下面积（AUC）分别为0.843，0.849，两者联合预测的AUC为0.941，优于两者各自单独预测（Z=1.725，1.882，P<0.05），且特异度和敏感度分别为85.48%，94.44%。结论　先兆流产保胎治疗孕妇血清PCSK9 水平显著上调，CTRP6 水平显著下调，两者在预测先兆流产保胎治疗孕妇的妊娠结局中具有重要价值。
Abstract:
Objective　To explore the predictive value of serum proprotein convertase subtilisin/kexin type 9 (PCSK9) and proprotein convertase subtilisin/kexin type 9 (CTRP6) in pregnant women undergoing threatened abortion and fetal protection treatment for pregnancy outcomes. Methods　Eighty pregnant women with threatened abortion who were treated in the Second Affiliated Hospital of Shaanxi University of Chinese Medicine from August 2021 to May 2022 were selected as the study subjects. According to the pregnancy outcome, they were grouped into the good pregnancy outcome group (n=62) and the bad pregnancy outcome group (n=18), while another 60 pregnant women with normal pregnancy tests in the hospital were selected as the control group. The serum levels of PCSK9, CTRP6, progesterone and β-human chorionic gonadotropin (β-HCG) were measured by enzyme-linked immunosorbent assay (ELISA). Pearson method was applied to analyze the correlation between serum PCSK9, CTRP6 levels and progesterone and β-HCG levels. Multivariate Logistic regression analysis was applied to analyze the factors affecting the pregnancy outcomes of pregnant women with threatened abortion. The predictive value of serum PCSK9 and CTRP6 on pregnancy outcome of pregnant women with threatened abortion and pregnancy protection treatment was analyzed by the receiver operating characteristic (ROC) curve. Results　The level of progesterone (45.65 ± 3.48, 38.29 ± 3.54 and 31.56 ± 4.11 nmol/L), β-HCG (32 056.56 ± 4 244.54, 23 642.32 ± 3 897.67 and 11 375.56 ± 3 454.35 mIU/L) and CTRP6 (436.53 ± 36.23, 328.44 ± 31.06 and 277.86 ± 25.56 ng/ml) in control group, good pregnancy outcome group and bad pregnancy outcome group decreased gradually, while the level of PCSK9 (64.22 ± 10.35, 82.24 ± 13.33 and 114.56 ± 17.67 ng/ml) in the control group, the good pregnancy outcome group and the bad pregnancy outcome group increased gradually, with statistically significant differences (F=129.231, 199.334, 244.007, 111.297, all P<0.05). Pearson method showed that serum PCSK9 was negatively correlated with progesterone and β-HCG levels (r=-0.545, -0.514, all P<0.05), and serum CTRP6 was positively correlated with progesterone and β-HCG levels (r=0.567, 0.496, all P<0.05). Multivariate Logistic regression analysis showed that the high level of PCSK9 was an independent risk factor for pregnancy outcome of threatened abortion and fetal protection treatment, and the high level of CTRP6, progesterone and β-HCG were independent protective factors for pregnancy outcome of threatened abortion and fetal protection treatment (P<0.05). ROC results showed that the area under the curve (AUC) of serum PCSK9 and CTRP6 levels for patients with adverse pregnancy outcomes in the prediction of threatened abortion and fetal protection treatment was 0.843 and 0.849, respectively. The AUC predicted by the combination of the two was 0.941, which was better than that predicted by each individual (Z=1.725, 1.882, P<0.05), with a specificity and a sensitivity of 85.48%, 94.44%, respectively. Conclusion　The serum PCSK9 level of pregnant women undergoing threatened abortion and fetal protection treatment was obviously increased, and the level of CTRP6 was obviously reduced. This study indicated both have important value in predicting the pregnancy outcomes of pregnant women undergoing threatened abortion and fetal protection treatment.

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备注/Memo

备注/Memo:
基金项目：陕西省卫生健康科研基金项目（编号：2018D085）：陕西咸阳地区妊娠期甲减的流行病学研究。
作者简介：段宁娟（1988-），女，硕士，主治医师，研究方向：流产保胎治疗，E-mail：Dnjuan23@163.com。
通讯作者：王振威（1991-），男，硕士，主治医师，研究方向：妇产科，E-mail：314844671@qq.com。
更新日期/Last Update: 2024-01-15