| 张虹.张虹 血浆蛋白C、抗凝血酶Ⅲ、T淋巴亚群水平对早期复发性流产的预测价值分析[J].浙江中西医结合杂志,2026,36(5): |
| 张虹 血浆蛋白C、抗凝血酶Ⅲ、T淋巴亚群水平对早期复发性流产的预测价值分析 |
Analysis of the predictive value of plasma protein C, antithrombin Ⅲ, and T lymphocyte subsets levels for early recurrent miscarriage
Zhang Hong1 Chen Leilei1 Zhang Guojing2 Chen Xiangyi 1 Liu Yuqi 3*1Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, Zhejiang 325000, China |
| 投稿时间：2025-02-24 修订日期：2026-02-03 |
| DOI： |
| 中文关键词: 蛋白C 抗凝血酶Ⅲ T淋巴亚群 复发性流产 妊娠结局 预测价值 |
| 英文关键词:protein C antithrombin Ⅲ T lymphocyte subpopulation recurrent spontaneous abortion pregnancy outcome predictive value |
| 基金项目:温州市基础性公益科研项目，Y2023234 |
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| 中文摘要: |
| 目的 分析血浆蛋白C(PC)、抗凝血酶Ⅲ(AT-Ⅲ)、T淋巴亚群水平对早期复发性流产(RSA)的预测价值。方法 从2023年7月-2024年7月到我院诊疗的孕妇中选取40例早期RSA患者为RSA组。另选取同期到院孕检的60例正常妊娠孕妇为正常组。比较两组患者的血浆PC、AT-Ⅲ、T淋巴亚群(CD3+、CD4+、CD8+)水平。再经logistic回归分析、受试者操作特征(ROC)曲线分析评估血浆PC、AT-Ⅲ、T淋巴亚群水平对早期RSA的单项及联合预测价值。结果 RSA组的血浆PC、AT-Ⅲ水平分别为(70.62±10.07)%、(71.45±10.52)%,正常组的血浆PC、AT-Ⅲ水平分别为(83.15±11.33)%、(85.01±12.68)%,RSA组的指标水平明显更低(均P＜0.001)。 RSA组的CD3+、CD4+、CD8+细胞百分比分别为(71.12±6.11)%、(38.77±5.81)%、(26.75±4.20)%,而正常组的CD3+、CD4+、CD8+细胞百分比分别为(67.85±6.02)%、(32.65±6.24)%、(28.71±4.61)%,两组组间比较存在显著差异(均P＜0.05)。PC、AT-Ⅲ、CD8+水平高是早期RSA的保护因素(OR=0.907、0.846、0.844,均P＜0.05),CD3+、CD4+水平高是早期RSA的危险因素(OR=1.071、1.179,均P＜0.05)。ROC曲线分析显示,血浆PC、AT-Ⅲ、CD3+、CD4+、CD8+单项与联合检测的曲线下面积(AUC)依次是0.807、0.793、0.658、0.761、0.427、0.905,联合检测的预测效能更高。结论 血浆PC、AT-Ⅲ和T淋巴细胞亚群水平的变化可作为早期RSA的重要预测指标,通过联合检测有助于早期诊断和治疗策略的制定。 |
| 英文摘要: |
| Objective To analyze the predictive value of plasma protein C (PC), antithrombin Ⅲ (AT-Ⅲ), and T lymphocyte subsets levels for early recurrent spontaneous abortion (RSA). Method From July 2023 to July 2024, 40 pregnant women with early RSA were selected as RSA group. Another 60 normal pregnant women who underwent pregnancy check ups at the same time were selected as the normal group. The levels of plasma PC, AT-III and T lymphocyte subsets ( CD3 +, CD4 +, CD8 + ) were compared between the two groups. Logistic regression analysis and receiver operating characteristic ( ROC ) curve analysis were used to evaluate the single and combined predictive value of plasma PC, AT-III and T lymphocyte subsets for early RSA. Result The levels of plasma PC and AT-III in RSA group were ( 70.62±10.07 ) % and ( 71.45±10.52 ) %, respectively. The levels of plasma PC and AT-III in normal group were ( 83.15±11.33 ) % and ( 85.01±12.68 ) %, respectively. The levels of plasma PC and AT-III in RSA group were significantly lower ( all P < 0.001 ). The percentages of CD3 +, CD4 + and CD8 + cells in the RSA group were ( 71.12±6.11 ) %, ( 38.77±5.81 ) % and ( 26.75±4.20 ) %, respectively, while the percentages of CD3 +, CD4 + and CD8 + cells in the normal group were ( 67.85±6.02 ) %, ( 32.65±6.24 ) % and ( 28.71±4.61 ) %, respectively. There were significant differences between the two groups ( all P < 0.05 ). High levels of PC, AT-III and CD8 + were protective factors for early RSA ( OR = 0.907, 0.846, 0.844, all P < 0.05 ), and high levels of CD3 + and CD4 + were risk factors for early RSA ( OR = 1.071, 1.179, all P < 0.05 ). ROC curve analysis showed that the area under the curve ( AUC ) of plasma PC, AT-III, CD3 +, CD4 +, CD8 + single and combined detection were 0.807, 0.793, 0.658, 0.761, 0.427, 0.905, respectively, and the combined detection had higher predictive efficiency. Conclusion The changes of plasma PC, AT-III and T lymphocyte subsets can be used as important predictors of early RSA, and combined detection is helpful for early diagnosis and treatment strategy formulation. |
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