摘要
目的探讨自然杀伤(NK)细胞及辅助性T细胞(Th)细胞因子水平预测高危型人乳头瘤病毒(HR-HPV)感染者辅助生殖妊娠结局。方法选取2021年9月至2023年6月就诊于该院接受辅助生殖治疗的128例HR-HPV感染者作为研究对象,根据患者妊娠结局划分为正常妊娠结局组(n=87)和不良妊娠结局组(n=41)。收集并对比两组患者临床资料、接受体外受精-胚胎移植治疗前NK细胞比例、白细胞介素(IL)-2、IL-4、IL-6及IL-10水平。通过Spearman相关性分析、单因素Logistic回归分析及多因素Logistic回归分析筛选出接受辅助生殖的HR-HPV感染者不良妊娠结局的危险因素,并通过受试者工作特征(ROC)曲线、曲线下面积(AUC)评价各危险因素单独及联合对接受辅助生殖的HR-HPV感染者不良妊娠结局的预测效能。结果不良妊娠结局组年龄显著大于正常妊娠结局组,差异有统计学意义(P<0.05)。不良妊娠结局组NK细胞比例、IL-10水平均显著低于正常妊娠结局组,IL-6水平显著高于正常妊娠结局组,差异有统计学意义(P<0.05)。Spearman相关性分析表明HR-HPV感染者年龄、IL-6水平均与辅助生殖后不良妊娠结局呈正相关(r=0.582、0.341,P<0.001),NK细胞比例、IL-10水平均与辅助生殖后不良妊娠结局呈负相关(r=-0.459、-0.359,P<0.001)。多因素Logistic回归分析结果表明,HR-HPV感染者NK细胞比例、IL-10低水平,IL-6高水平均是辅助生殖后不良妊娠结局的危险因素(P<0.05)。ROC曲线分析结果显示,NK细胞比例、IL-6、IL-10单独及3项联合预测HR-HPV感染者辅助生殖后不良妊娠结局的AUC分别为0.784、0.711、0.660及0.876,其中3项联合预测的效能大于各指标独立预测的效能(Z=3.006、3.211、3.716,P<0.05)。结论NK细胞及Th细胞因子水平对HR-HPV感染者辅助生殖妊娠结局的预测具有重要的临床意义。
Objective To investigate the prediction of natural killer(NK)cells,and T helper cells(Th)cytokine levels for assisted reproductive pregnancy outcomes in high-risk human papillomavirus(HR-HPV)infected patients.Methods A total of 128 cases of HR-HPV infected patients who received assisted reproductive treatment in a hospital from September 2021 to June 2023 were selected as the study objects,and were divided into normal pregnancy outcome group(n=87)and adverse pregnancy outcome group(n=41)according to their pregnancy outcomes.The clinical data,NK cell proportion,interleukin(IL)-2,IL-4,IL-6 and IL-10 levels before in vitro fertilization-embryo transfer treatment were collected and compared between the two groups.Spearman correlation analysis,univariate Logistic regression analysis and multiple Logistic regression analysis were used to screen out the risk factors for adverse pregnancy outcomes in HR-HPV infected patients receiving assisted reproduction.Receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to evaluate the predictive efficacy of risk factors alone and in combination for adverse pregnancy outcomes in HR-HPV infected patients undergoing assisted reproduction.Results The age of the adverse pregnancy outcome group was significantly higher than that of the normal pregnancy outcome group,and the difference was statistically significant(P<0.05).The proportion of NK cells and the level of IL-10 in the adverse pregnancy outcome group were significantly lower than those in the normal pregnancy outcome group,and the level of IL-6 was significantly higher than that in the normal pregnancy outcome group,with statistical significance(P<0.05).Spearman correlation analysis showed that age and IL-6 level of HR-HPV infection were positively correlated with adverse pregnancy outcome after assisted reproduction(r=0.582,0.341,P<0.001).The proportion of NK cells and the level of IL-10 were negatively correlated with adverse pregnancy outcomes after assisted reproduction(r=-0.459,-0.359,P<0.001).Multivariate Logistic regression analysis showed that the proportion of NK cells,low level of IL-10 and high level of IL-6 in HR-HPV infected persons were risk factors for adverse pregnancy outcomes after assisted reproduction(P<0.05).ROC curve analysis results showed that the AUC of NK cell ratio,IL-6 and IL-10 alone and in combination to predict adverse pregnancy outcome after assisted reproduction in HR-HPV infected patients were 0.784,0.711,0.660 and 0.876,respectively.The efficiency of combined prediction using the three indicators was higher than that of independent prediction(Z=3.006,3.211,3.716,P<0.05).Conclusion The levels of NK cells and Th cytokines have important clinical significance in the prediction of assisted reproductive pregnancy outcome in HR-HPV infected patients.
作者
温海玲
李浩僡
周立花
WEN Hailing;LI Haohui;ZHOU Lihua(Department of Reproductive Medicine,Second Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570311,China)
出处
《国际检验医学杂志》
2025年第4期404-408,共5页
International Journal of Laboratory Medicine
基金
海南省卫生健康行业科研项目(21A200332)。
关键词
自然杀伤细胞
高危人乳头瘤病毒
辅助生殖
natural killer cells
high risk human papillomavirus
assisted reproduction
作者简介
温海玲,女,主治医师,主要从事生殖医学方面研究。
