α1 抗胰蛋白酶、D-二聚体及同型半胱氨酸联合检测对先兆流产患者妊娠结局的预测效能

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Abstract Objective To investigate the predictive efficacy of combined detection of α1-antitrypsin (AAT),D-dimer(D-D) and homocysteine (Hcy) on pregnancy outcome in patients with threatened abortion.Methods The clinical data of 100 patients with threatened abortion who received tocolysis treatment in Pingxiang People's Hospital from June 2021 to January 2023 were retrospectively analyzed.According to the pregnancy outcome,they were divided into tocolysis failure group and tocolysis success group.The baseline data,serum AAT,D-D and Hcy levels in early pregnancy were compared between the two groups.Logistic regression analysis was used to explore the relationship between serum AAT,D-D and Hcy levels and pregnancy outcome in patients with threatened abortion.The ROC curve was used to analyze the predictive efficacy of serum AAT,D-D and Hcy levels on pregnancy outcome in patients with threatened abortion.Results Among the 100 patients with threatened abortion,20 cases (20.00%)had inevitable abortion and 15 cases (15.00%)had delayed abortion after tocolytic therapy,which were included in the tocolysis failure group,65 cases (65.00%)continued pregnancy to successful delivery and were included in the tocolysis success group.The level of serum AAT in the tocolysis failure group was lower than that in the tocolysis success group before the treatment,and the levels of D-D and Hcy were higher than those in the tocolysis success group,and the differences were statistically significant (P＜0.05).Logistic regression analysis showed that higher serum AAT (β=-1.769,OR=0.170,95%CI=0.068-0.429) was a independent protective factor for pregnancy outcome in patients with threatened abortion,and higher D-D (β=2.504,OR=12.229,95%CI=4.037-37.045) and Hcy(β=0.612,OR=1.844,95%CI=1.212-2.804) were independent risk factors for pregnancy outcome in patients with threatened abortion(P＜0.05).The ROC curve showed that serum AAT,D-D and Hcy levels could be used to predict the pregnancy outcome of patients with threatened abortion.The combined prediction of the three had the highest prediction efficiency,and the AUC was 0.898,the sensitivity and specificity were 88.57% and 78.46%,respectively.Conclusion The levels of serum AAT,D-D and Hcy are related to the pregnancy outcome of patients with threatened abortion.If there is low expression of AAT,high expression of D-D and Hcy in clinical practice,threatened abortion should be alerted.

Key words： Threatened abortion Pregnancy outcome &alpha 1 antitrypsin D-dimer Homocysteine

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CHEN Bo. Predictive efficacy of combined detection of α1 antitrypsin,D-dimer and homocysteine on pregnancy outcome in patients with threatened abortion[J]. 中国当代医药, 2024, 31(15): 14-17转23.

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https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2024/V31/I15/14

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