摘要
目的探究外周血中抗β2-糖蛋白Ⅰ抗体(anti-β-2 glycoproteinⅠantibody,A-β2GPⅠ)、同型半胱氨酸(homocysteine,Hcy)及血栓前状态与不明原因复发性流产发生风险的关系。方法选取2020年4月至2023年5月九江市妇幼保健院收治的90例不明原因复发性流产患者作为观察组,另选取同期于本院体检的80名女性健康体检者作为对照组。比较两组外周血A-β2GPⅠ-ⅠgA、A-β2GPⅠ-ⅠgM、A-β2GPⅠ-ⅠgG、Hcy、血栓前状态[纤维蛋白原(fibrinogen,Fg)、D二聚体(D-dimer,D-D)、P选择素、纤溶酶原激活抑制物-1(plasminogen activator inhibitor-1,PAI-1)、组织纤溶酶原激活物(tissue plasminogen activator,tPA)及血小板第四因子(platelet factor 4,PF4)]及炎症小体[Toll样受体4(toll-like receptor 4,TLR4)、凋亡相关斑点样蛋白(apoptosis-associated speck-like protein,ASC)及NOD样受体蛋白3(nucleotide-binding oligomerization domain-like receptor 3,NLRP3)]mRNA水平,多因素Logistic回归分析不明原因复发性流产的影响因素。结果两组A-β2GPⅠ-ⅠgG水平比较差异无统计学意义;观察组A-β2GPⅠ-ⅠgA、A-β2GPⅠ-ⅠgM及Hcy水平均高于对照组,差异有统计学意义(P<0.05);观察组Fg、D-D、P选择素、PAI-1、tPA及PF4水平均高于对照组,差异有统计学意义(P<0.05);观察组TLR4、ASC及NLRP3的mRNA水平均高于对照组,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,A-β2GPⅠ-ⅠgM、Hcy、Fg、D-D、PAI-1、tPA、P选择素、PF4、TLR4 mRNA、NLRP3 mRNA及ASC mRNA是不明原因复发性流产的独立危险因素(P<0.05)。结论A-β2GPⅠ-ⅠgM、Hcy及血栓前状态是不明原因复发性流产的独立危险因素,在今后的临床工作中应密切关注上述指标水平,在妊娠早期及积极开展相关干预措施,以改善妊娠结局。
Objective To investigate the relationship between peripheral blood levels ofβ-2 glycoproteinⅠantibody(A-β2GPⅠ),homocysteine(Hcy),prothrombotic status and recurrent abortion of unknown cause.Methods A total of 90 patients with recurrent abortion of unknown cause admitted to the Jiujiang Maternal and Child Health Hospital from April 2020 to May 2023 were selected as the observation group,additionally,80 healthy women undergoing routine physical examination at the our hospital during the same period were selected as the control group.The peripheral blood levels of A-β2GPⅠ-ⅠgA,A-β2GPⅠ-ⅠgM,A-β2GPⅠ-ⅠgG,Hcy,prothrombotic status(fibrinogen[Fg],D-dimer[D-D],P-selectin,plasminogen activator inhibitor-1[PAI-1],tissue plasminogen activator[tPA]and platelet factor 4[PF4])and inflammasome(toll-like receptor 4[TLR4],apoptosis-associated speck-like protein[ASC]and nucleotide-binding oligomerization domain-like receptor 3[NLRP3])mRNA levels were compared between the two groups,multifactor Logistic regression analysis was used to analyze the influencing factors of recurrent abortion of unknown cause.Results There was no significant difference in A-β2GPⅠ-ⅠgG between the two groups,the levels of A-β2GPⅠ-ⅠgA,A-β2GPⅠ-ⅠgM and Hcy in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05);the levels of Fg,D-D,P-selectin,PAI-1,tPA and PF4 in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05);the levels of TLR4 mRNA,ASC mRNA and NLRP3 mRNA in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05);multifactor Logistic regression analysis showed that A-β2GPⅠ-IgM,Hcy,Fg,D-D,PAI-1,tPA,Pselectin,PF4,TLR4 mRNA,NLRP3 mRNA and ASC mRNA were the independent risk factors of recurrent abortion of unknown cause(P<0.05).Conclusions A-β2GPⅠ-IgM,Hcy and prethrombotic state are the independent risk factors of recurrent abortion of unknown cause,in the future clinical work,we should pay close attention to the levels of the above indicators,and carry out active intervention measures in the early pregnancy to improve the pregnancy outcome.
作者
陈英
周芸
夏乐莎
CHEN Ying;ZHOU Yun;XIA Lesha(Department of Gynecology,Jiujiang Maternal and Child Health Hospital,Jiujiang,Jiangxi,332000,China)
出处
《当代医学》
2024年第34期89-93,共5页
Contemporary Medicine
