[1]王利伶,张 银,于 波.初分娩后血清TIMP-1 和Fibulin-3 水平变化及对产后盆底功能障碍的诊断价值[J].现代检验医学杂志,2024,39(05):179-182+198.[doi:10.3969/j.issn.1671-7414.2024.05.033]
　WANG Liling,ZHANG Yin,YU Bo.Changes of Serum TIMP-1 and Fibulin-3 Levels after First Delivery and Their Diagnostic Value for Postpartum Pelvic Floor Dysfunction[J].Journal of Modern Laboratory Medicine,2024,39(05):179-182+198.[doi:10.3969/j.issn.1671-7414.2024.05.033]
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初分娩后血清TIMP-1 和Fibulin-3 水平变化及对产后盆底功能障碍的诊断价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年05期
页码:
179-182+198
栏目:
论著
出版日期:
2024-09-15

文章信息/Info

Title:
Changes of Serum TIMP-1 and Fibulin-3 Levels after First Delivery and Their Diagnostic Value for Postpartum Pelvic Floor Dysfunction
文章编号:
1671-7414（2024）05-179-05
作者:
王利伶; 张 银; 于 波
（承德市妇幼保健院产科，河北承德 067000）
Author(s):
WANG Liling;  ZHANG Yin;  YU Bo
（Department of Obstetrics, Chengde Maternal and Child Health Hospital, Hebei Chengde 067000, China）
关键词:
盆底功能障碍; 金属蛋白酶抑制因子-1; 细胞外基质蛋白-3
分类号:
R714.69；R392.11
DOI:
10.3969/j.issn.1671-7414.2024.05.033
文献标志码:
A
摘要:
目的 探究初分娩后血清金属蛋白酶抑制因子-1（tissue inhibitor of metalloproteinase-1，TIMP-1）、细胞外基质蛋白-3（extracellular matrix protein-3, Fibulin-3）水平变化及其对产后盆底功能障碍（pelvic floor dysfunction，PFD）的诊断价值，为PFD 临床研究提供参考。方法 选取2021 年6 月~2022 年6 月在承德市妇幼保健院收治的PFD 患者98 例作为研究对象，将患者分为单纯盆腔脱垂（POP）组（n=34）、单纯压力性尿失禁（SUI）组（n=51）以及POP并发SUI 组（n=13）。同期选取产后复查无PFD 初产女性98 例作为对照组。比较各组血清TIMP-1，Fibulin-3 水平。受试者工作特征（ROC）曲线分析血清TIMP-1，Fibulin-3 水平对PFD 的预测效能。结果 PFD 组第二产程时间延长患者比例比对照组高，差异具有统计学意义（t=20.933，P ＜ 0.05）。PFD 组血清TIMP-1（3.68±0.41ng/ml），Fibulin-3（20.18±2.29ng/ml）水平比对照组（4.25±0.53ng/ml,23.04±2.64ng/ml）低, 差异具有统计学意义（t=8.421，8.101，均P ＜ 0.05）。POP 并发SUI 组血清TIMP-1，Fibulin-3 水平低于单纯POP 组和单纯SUI 组，差异具有统计学意义（F=21.940，14.871，均P ＜ 0.05）。随着单纯POP 组与单纯SUI 组患者病情加重，血清TIMP-1，Fibulin-3 水平逐渐降低（F=8.411,13.173,18.425,10.965, 均P ＜ 0.05）。ROC 曲线显示，血清TIMP-1，Fibulin-3 预测发生PFD 的AUC 是0.770，0.784，二者联合预测的AUC 为0.893，优于单独检测（Z=2.996，2.766，均P ＜ 0.05）。结论 PFD 患者血清TIMP-1，Fibulin-3 水平降低，且二者联合预测效能高于单独检测，可作为预测产后PFD 的血清学指标。
Abstract:
Objective To explore the changes of serum tissue inhibitor of metalloproteinase-1 (TIMP-1) and extracellular matrix protein-3 (Fibulin-3) levels after the first delivery, and their diagnostic value for postpartum pelvic floor dysfunction (PFD), and provide a reference for clinical research of PFD. Methods A total of 98 patients with PFD admitted to Chengde Maternal and Child Health Hospital from June 2021 to June 2022 were selected as study subjects, and the patients were categorized into the pure pelvic prolapse (POP) group (n=34), the pure stress urinary incontinence (SUI) group (n=51), and the POP-combined SUI group (n=13). In the same period, 98 women who underwent postpartum review for primiparous delivery without PFD were selected as the control group. Serum TIMP-1 and Fibulin-3 levels were compared between the groups. The predictive efficacy of serum TIMP-1 and Fibulin-3 levels for PFD was analyzed by ROC. Results The proportion of patients with prolonged duration of the second stage of labor in the PFD group was higher than that in the control group, and the difference was statisticlly significant (t=20.933, P<0.05). Serum TIMP-1(3.68±0.41ng/ml) and Fibulin-3 (28.18±2.29ng/ml) levels in the PFD group were lower than those in the control group (4.25±0.53ng/ml,23.04±2.64ng/ml), and the differenes were statistically significant (t=8.421, 8.101, all P<0.05). Serum TIMP-1 and Fibulin-3 levels in the POP combined with SUI group were lower than those in the POP alone group and SUI-only group (F=21.940, 14.871, all P<0.05). As the condition of the patients in the POP-only group and the SUIonly group worsened, the serum TIMP-1 and Fibulin-3 levels were gradually decreased (F=8.411，13.173，18.425，10.965，all P<0.05). ROC curves showed that the AUCs of serum TIMP-1 and Fibulin-3 alone and the combination of the two for the prediction of the occurrence of PFD were 0.770, 0.784 and 0.893, respectively, which the AUC of combination detection was superior to that of the test alone (Z=2.996, 2.766, all P<0.05). Conclusion Serum TIMP-1 and Fibulin-3 levels are reduced in patients with PFD, and the combined predictive efficacy of the two is higher than that of the alone tests, which can be used as a serologic predictor of postpartum PFD.

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备注/Memo

备注/Memo:
基金项目：2023 年承德市科技计划自筹经费项目（项目编号：202301A006）。
作者简介：王利伶（1973-），女，本科，副主任医师，研究方向：产科疾病治疗，E-mail：r16hin@163.com。
通讯作者： 张银（1990-），女，本科，副主任医师，研究方向：产科疾病治疗，E-mails：g73tvd@163.com。
更新日期/Last Update: 2024-09-15