标题：血清孕酮、β-HCG、INF-γ及 IL-10检测预测黄体功能不足性流产患者保胎结局的价值

      作者：张利平 1，武琳琳 2，韩继荣 2    西北妇女儿童医院医学遗传中心 1、妇女保健科 2，陕西 西安 710000

      卷次： 2024年35卷4期

      【摘要】 目的 探讨血清孕酮、β-绒毛膜促性腺激素(β-HCG)、γ干扰素(INF-γ)及白介素-10 (IL-10)检测预测黄体功能不足性流产患者保胎结局的价值。方法 回顾性选取2021年1月至2022年12月在西北妇女儿童医院治疗的96例黄体功能不足先兆性流产患者纳入观察组，选择同期产检的103例健康孕妇纳入对照组，比较两组孕妇孕6周、8周及10周的血清孕酮、β-HCG、INF-γ及 IL-10水平；按观察组孕妇的保胎结局分为保胎成功组 74例和妊娠失败组22例，采用Pearson法分析血清孕酮、β-HCG、INF-γ及 IL-10水平与保胎结局的相关性，绘制受试者工作特征曲线(ROC)得到曲线下面积(AUC)，以AUC评价孕酮、β-HCG、INF-γ及 IL-10对黄体功能不足性先兆流产患者保胎结局的预测效能。结果 观察组孕妇孕 6周、8周和 10周的孕酮、β-HCG和 IL-10水平明显低于对照组，但INF-γ水平明显高于对照组，差异均有统计学意义(P<0.05)；保胎成功组孕妇孕10周孕酮、β-HCG]及 IL-10水平明显高于妊娠失败组，但 INF-γ明显低于妊娠失败组，差异均有统计学意义(P<0.05)；经Pearson相关性分析结果显示，孕10周孕酮、β-HCG及 IL-10与保胎结局呈正相关(P<0.05)，INF-γ与保胎结局呈负相关(P<0.05)；经ROC分析结果显示，孕 10周的孕酮、β-HCG、INF-γ及 IL-10预测黄体功能不足先兆性流产患者保胎结局的AUC分别为 0.953、0.853、0.897、0.875，均具有较好预测价值(P<0.05)。结论 孕酮、β-HCG、IL-10及 INF-γ与黄体功能不足先兆性流产患者保胎结局密切相关，可作为其保胎结局的预测指标。
      【关键词】 黄体功能不足先兆性流产；血清孕酮；β-绒毛膜促性腺激素；γ干扰素；白介素-10；保胎结局
      【中图分类号】 R169.42 【文献标识码】 A 【文章编号】 1003—6350（2024）04—0542—05

Value of serum progesterone, β-HCG, INF-γ, and IL-10 in predicting fetus-protection outcomes of patientswith threatened abortion due to luteal phase defect.
ZHANG Li-ping 1, WU Lin-lin 2, HAN Ji-rong 2. Center of MedicalGenetics 1, Department of Women's Health Care 2, Northwest Women’s and Children's Hospital, Xi’an 710000, Shaanxi,CHINA
【Abstract】 Objective To investigate the value of serum progesterone, β-human chorionic gonadotropin( β-HCG), interferon γ (INF-γ), and interleukin-10 (IL-10) in predicting fetus-protection outcomes of patients withthreatened abortion due to luteal phase defect. Methods A total of 96 patients with threatened abortion due to lutealphase defect who were treated in Northwest Women's and Children's Hospital from January 2021 to December 2022were selected as the observation group. Meanwhile, 103 healthy pregnant women were selected as the control group. Se-rum progesterone, β-HCG, INF-γ, and IL-10 levels after 6 weeks, 8 weeks and 10 weeks of gestation were comparedbetween the two groups. Pregnant women in the observation group were divided into the successful fetus protectiongroup (74 cases) and the pregnancy failure group (22 cases) according to fetus-protection outcomes. The correlation be-tween serum progesterone, β-HCG, INF-γ, IL-10 levels and fetus-protection outcomes was analyzed by Pearson meth-od. The predictive efficacy of progesterone, β-HCG, INF-γ, and IL-10 for fetus-protection outcomes of patients withthreatened abortion due to luteal phase defect was evaluated using area under the the receiver operating characteristic(ROC) curves (AUC). Results After 6 weeks, 8 weeks, and 10 weeks of gestation, the levels of progesterone, β-HCG,and IL-10 in pregnant women in the observation group were significantly lower than those in the control group; INF-γlevels were significantly higher than those in the control group; the differences were statistically significant (P<0.05).The levels of progesterone, β-HCG, and IL-10 in pregnant women in the successful fetus protection group at 10 weeksof gestation were significantly higher than those in the pregnancy failure group, and the level of INF-γ was significantlylower than that in the pregnancy failure group, with statistically significant differences (P<0.05). Pearson correlationanalysis results showed that progesterone, β-HCG, and IL-10 at 10 weeks of gestation were positively correlated with fe-tus-protection outcomes (P<0.05). INF-γ was negatively correlated with fetus-protection outcomes (P<0.05). ROCcurve analysis results showed that the AUC of progesterone, β-HCG, INF-γ, and IL-10 at 10 weeks of gestation for pre-dicting fetus-protection outcomes of patients with threatened abortion due to luteal phase defect were 0.953, 0.853,0.897, and 0.875, respectively, all with good predictive value (P<0.05). Conclusion Progesterone, β-HCG, INF-γ, andIL-10 are closely related to fetus-protection outcomes of patients with threatened abortion due to luteal phase defect,which indicates that these indicators can be used to predict fetus-protection outcomes.
      【Key words】 Threatened abortion due to luteal phase defect; Serum progesterone; β-human chorionic gonadotro-pin; Interferon γ; Interleukin-10; Fetus-protection outcome