原因不明复发性流产患者血清sFlt-1、E-cadherin、IFN-γ水平变化及其临床意义

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摘要 目的: 探讨原因不明复发性流产（unexplained recurrent spontaneous abortion,URSA）患者血清可溶性血管内皮生长因子受体1（soluble vascular endothelial growth factor receptor 1,sFlt-1）、E-钙黏蛋白（E-cadherin）、干扰素γ（interferon γ,IFN-γ）水平变化及其临床意义。方法: 选取2021年1月—2023年1月本院收治的146例URSA患者作为流产组,另选取同期进行产检的正常妊娠孕妇80例作为对照组,比较两组临床资料及血清sFlt-1、E-cadherin、IFN-γ水平变化,采用多因素Logistic回归分析URSA发生的影响因素,并分析sFlt-1、E-cadherin、IFN-γ对URSA的预测价值。结果: 流产组血清sFlt-1、IFN-γ水平高于对照组,E-cadherin低于对照组;Pearson相关性分析显示,URSA患者血清sFlt-1水平与E-cadherin呈负相关,与IFN-γ呈正相关（r=-0.286;r=0.392,P<0.05）。URSA患者血清E-cadherin水平与IFN-γ呈负相关（r=-0.272,P<0.05）;二元Logistic回归分析显示,年龄、sFlt-1、E-cadherin、IFN-γ均为影响URSA发生的独立危险因素;ROC曲线显示,血清sFlt-1、E-cadherin、IFN-γ联合预测URSA的AUC为0.909,高于sFlt-1的0.864、E-cadherin的0.666、IFN-γ的0.764（Z=2.892;Z=6.562;Z=4.089,P<0.05）。结论: URSA患者血清sFlt-1、IFN-γ水平升高,E-cadherin水平降低,三者对URSA有一定预测诊断价值。

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关键词 ：原因不明复发性流产, 可溶性血管内皮生长因子受体1, E-钙黏蛋白, 干扰素

Abstract：Objective To explore the changes and clinical significance of serum soluble vascular endothelial growth factor receptor-1 (sFlt-1) , E-cadherin and interferon γ (IFN-γ) in patients with unexplained recurrent spontaneous abortion (URSA). Methods A total of 146 patients with URSA and 80 normal pregnant women who underwent prenatal examination were enrolled as abortion group and control group between January 2021 and January 2023, respectively. The clinical data and changes of serum sFlt-1, E-cadherin and IFN-γ in the two groups were compared. The influencing factors of URSA were analyzed by multivariate Logistic regression analysis, and the predictive value of sFlt-1, E-cadherin and IFN-γ for URSA was analyzed. Results The levels of serum sFlt-1 and IFN-γ in abortion group were higher than those in control group, while E-cadherin level was lower than that in control group (t=8.520; t=4.254; t=6.643, P<0.05) . Pearson correlation analysis showed that serum sFlt-1 level in URSA patients was negatively correlated with E-cadherin, while positively correlated with IFN-γ (r=-0.286; r=0.392, P<0.05) . Serum E-cadherin in URSA was negatively correlated with IFN-γ (r=-0.272, P<0.05) . Binary Logistic regression analysis showed that age, sFlt-1, E-cadherin and IFN-γ were independent risk factors of URSA. ROC curves analysis showed that AUC of serum sFlt-1 combined with E-cadherin and IFN-γ for predicting URSA was 0.909, greater than that of single index (0.864, 0.666, 0.764, Z=2.892; Z=6.562; Z=4.089, P<0.05) . Conclusion The levels of serum sFlt-1 and IFN-γ are increased, while E-cadherin level is decreased in URSA patients, and all the three indexes have certain value in the prediction and diagnosis of URSA.

Key words： unexplained recurrent spontaneous abortion soluble vascular endothelial growth factor receptor 1 E-cadherin interferon γ

收稿日期: 2024-03-18

基金资助:陕西省科技厅重点研发计划项目“Hcy及其代谢相关酶基因多态性与不明原因复发性流产的关系”（2017SF-062）

通讯作者: 张坤,E-mail：yo2024da@163.com

引用本文:

李欢, 张坤. 原因不明复发性流产患者血清sFlt-1、E-cadherin、IFN-γ水平变化及其临床意义[J]. 湖南师范大学学报(医学版), 2024, 21(4): 65-68. LI Huan, ZHANG Kun. Changes and clinical significance of serum sFlt-1, E-cadherin and IFN-γ in patients with unexplained recurrent spontaneous abortion. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(4): 65-68.

链接本文:

http://yxb.hunnu.edu.cn/CN/ 或 http://yxb.hunnu.edu.cn/CN/Y2024/V21/I4/65

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