摘要
目的探讨子宫内膜容受性相关调控因子白细胞介素-6(interleukin-6,IL-6)、胎盘蛋白14(placental protein14,PP14)、半乳糖凝集素-3(galactin-3,Gal-3)对冻融胚胎移植(frozen-thawed embryo transfer,FET)妊娠失败的预测价值。方法选取2021年4月—2023年1月于河南省生殖妇产医院接受FET的118例不孕症患者为研究对象,根据移植28 d后临床妊娠结局将患者分为妊娠组(75例)和妊娠失败组(43例)。比较2组血清IL-6、PP14、Gal-3水平,分析各指标水平与妊娠失败的相关性,ROC分析各指标水平联合检测对FET患者妊娠失败的预测价值,并分析各指标不同水平FET患者妊娠失败的危险度。结果对比不同妊娠结局接受FET的不孕症患者基本情况差异无统计学意义(P>0.05);移植后10 d妊娠失败组血清IL-6、Gal-3水平较高,PP14水平较低,t值分别为24.527、23.652、17.505,差异有统计学意义(P<0.05);移植后10 d妊娠失败组血清IL-6、Gal-3水平高于妊娠组,r值分别为0.622、0.691,且与妊娠失败呈正相关,PP14水平低于妊娠组,r值为-0.743,且与妊娠失败呈负相关(P<0.05);移植后10 d血清IL-6、PP14、Gal-3水平联合预测FET患者妊娠失败的曲线下面积(area under the curve,AUC)为0.801,最佳预测敏感度、特异度分别为90.70%、69.33%;且各指标高水平患者妊娠失败的危险度是低水平的1.977、0.298、2.738倍(P<0.05)。结论子宫内膜容受性相关调控因子IL-6、Gal-3、PP14各指标水平与FET妊娠结局密切相关,其联合检测对FET患者妊娠失败有预测价值,可作为临床早期预测FET妊娠结局的有效指标。
Objective To explore the predictive value of endometrial receptivity related regulatory factors interleukin-6(IL-6),placental protein 14(PP14)and galactin-3(Gal-3)on pregnancy failure in frozen-thawed embryo transfer(FET).Methods A total of 118 infertility patients who received FET in Henan Provincial Hospital of Reproductive Medicine,Obstetrics and Gynecology from April 2021 to January 2023 were selected as the study subjects.According to the clinical pregnancy outcomes at 28 days after transplantation,the patients were divided into the pregnancy group(n=75)and the pregnancy failure group(n=43).Serum levels of IL-6,PP14 and Gal-3 were compared between the two groups,and the correlations between each indicator level and pregnancy failure were analyzed.ROC analysis was performed to explore the predictive value of combined detection of the three indicators for pregnancy failure in the FET patients,and the risk of pregnancy failure in patients with different levels of each indicator was analyzed.Results In the comparison of different pregnancy outcomes,no statistically significant differences were found in the general conditions of infertility patients who received FET(P>0.05).Serum levels of IL-6 and Gal-3 were higher in the pregnancy failure group at 10 days after transplantation,but serum level of PP14 was lower.The t values were 24.527,23.652 and 17.505 respectively,showing statistically significant differences(P<0.05).At 10 days after transplantation,serum levels of IL-6 and Gal-3 were higher in the pregnancy failure group than in the pregnancy group(r=0.622,r=0.691),and positively correlated with pregnancy failure.Serum level of PP14 was lower in the pregnancy failure group than in the pregnancy group(r=-0.743),and negatively correlated with pregnancy failure(P<0.05).At 10 days after transplantation,the area under the curve(AUC)of combined detection of serum IL-6,PP14 and Gal-3 levels to predict pregnancy failure in the FET patients was 0.801.The best predictive sensitivity and specificity were 90.70% and 69.33% respectively,and the risk of pregnancy failure in patients with high levels of the three indicators was 1.977 and 0.298 and 2.738 times that of patients with the low levels(P<0.05).Conclusion Endometrial receptivity related regulatory factors,namely,serum IL-6,Gal-3 and PP14 levels are closely correlated with the pregnancy outcome of FET.Combined detection of the three indicators has a predictive value for pregnancy failure in the patients with FET,and can be used as an effective indicator for early prediction of pregnancy outcome of FET in clinical practice.
作者
曹丽幸
杨永俊
冯秋霞
包杰
CAO Lixing;YANG Yongjun;FENG Qiuxia;BAO Jie(Henan Provincial Hospital of Reproductive Medicine,Obstetrics and Gynecology,Zhengzhou,Henan 450002,China)
出处
《实用预防医学》
CAS
2024年第4期419-422,共4页
Practical Preventive Medicine
基金
河南省医学科技攻关计划项目(JBKY2021002)。
作者简介
曹丽幸(1984-),女,河南社旗人,学士,主管技师,研究方向:临床生化、内分泌。
