摘要
目的分析孕妇胎膜厚度、外周血辅助性T细胞17(Th17)/调节性T细胞(Treg)变化预测早产的价值。方法选取2020年1月-2021年8月海南医学院第二附属医院妇产科就诊的先兆早产孕妇102例为观察组,再根据是否早产分为非早产亚组37例和早产亚组65例,另选取同期正常产检孕妇102例为对照组。比较2组孕妇胎膜厚度、外周血Th17/Treg水平及不同亚组间临床资料,采用Logistic回归模型分析早产的影响因素,ROC曲线分析胎膜厚度、外周血Th17/Treg水平预测早产的价值,并比较观察组新生儿中早产儿和足月儿并发症发生率。结果观察组胎膜厚度、外周血Th17、Th17/Treg水平高于对照组,Treg水平低于对照组(t/P=3.976/<0.001,11.008/<0.001,39.875/<0.001,30.501/<0.001);早产亚组孕妇年龄≥30岁、孕周28~33周、妊娠期高血压疾病占比高于非早产亚组(χ2/P=6.585/0.010,4.184/0.041,3.972/0.046),胎膜厚度、Th17/Treg水平高于非早产亚组(t/P=2.837/0.006,3.210/0.002);胎膜厚度、Th17/Treg水平升高均是增加早产风险的独立危险因素[OR(95%CI)=3.683(1.869~7.257)、3.253(2.004~6.281)];胎膜厚度、Th17/Treg及二者联合预测早产的AUC为0.791、0.766、0.861,联合检测价值大于单项指标检测(Z/P=2.586/0.010,2.806/0.005);早产儿高胆红素血症、呼吸窘迫综合征发生率高于足月儿(χ2/P=4.067/0.044,8.074/0.005)。结论孕妇胎膜厚度增加、外周血Th17/Treg水平升高时存在早产风险,检测二者水平对早产预测具有较高价值,有利于减少新生儿并发症。
Objective To analyze the values of fetal membrane thickness and peripheral blood T helper 17(Th17)/regulatory T cells(Treg)changes in pregnant women in predicting preterm birth.Methods A total of 102 pregnant women with threatened preterm birth who visited the Department of Obstetrics and Gynecology of the Second Affiliated Hospital of Hainan Medical College from January 2020 to August 2021 were selected as the observation group,and then divided into a non-preterm subgroup of 37 cases and a preterm subgroup of 65 cases according to whether they were premature.Another 102 pregnant women with normal obstetric examination during the same period were selected as the control group.The fetal membrane thickness,peripheral blood Th17/Treg levels and clinical data between the two groups were compared between the two groups.Logistic regression model was used to analyze the influencing factors of preterm birth.The ROC curve was used to analyze the value of fetal membrane thickness and peripheral blood Th17/Treg levels in predicting preterm birth.The complication rates of premature infants and term infants in the observation group were compared.Results Membrane thickness,peripheral blood Th17 and Th17/Treg levels in the observation group were higher than those in the control group,and Treg levels were lower than those in the control group(t/P=3.976/<0.001,11.008/<0.001,39.875/<0.001,30.501/<0.001);Preterm birth subgroup was higher than that of non-preterm birth subgroup(χ2/P=6.585/0.010,4.184/0.041,3.972/0.046),fetal membrane Thickness and Th17/Treg levels were higher than those in the non-preterm subgroup(t/P=2.837/0.006,3.210/0.002);membrane thickness and Th17/Treg levels were both independent risk factors for increasing the risk of preterm birth[OR(95%)CI)=3.683(1.869-7.257),3.253(2.004-6.281)];the AUCs of membrane thickness,Th17/Treg and their combination in predicting preterm birth were 0.791,0.766,and 0.861,and the combined detection value was greater than the single index detection(Z/P=2.586/0.010,2.806/0.005);the incidence of hyperbilirubinemia and respiratory distress syndrome in preterm infants was higher than that in term infants(χ2/P=4.067/0.044,8.074/0.005).Conclusion Pregnant women at risk of preterm birth may have increased membrane thickness and increased peripheral blood Th17/Treg levels.Detection of the two levels is of high value in predicting preterm birth and is beneficial to reduce neonatal complications.
作者
陈秀敏
吴熊军
许文彬
邓乾葆
Chen Xiumin;Wu Xiongjun;Xu Wenbin;Deng Ganbao(Department of Obstetrics and Gynecology,Second Affiliated Hospital of Hainan Medical College,Hainan Province,Haikou 570311,China)
出处
《疑难病杂志》
CAS
2022年第8期794-799,共6页
Chinese Journal of Difficult and Complicated Cases
基金
海南省卫生健康行业科研项目(19A200503)。
作者简介
通信作者:吴熊军,E-mail:wuxiongjun@163.com。
