活化蛋白C、蛋白C在复发性流产合并抗磷脂综合征患者血浆中的表达水平及其临床意义

doi:10.3969/j.issn.1671-7171.2022.06.015

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摘要【目的】探讨活化蛋白C(APC)、蛋白C(PC)在复发性流产(RSA)合并抗磷脂综合征(APS)患者血浆中的表达水平及其临床意义。【方法】选取2017年8月至2020年1月榆林市第二医院诊治的123例RSA患者,根据患者是否合并APS分为单纯RSA组(63例)和RSA并发APS组(60例),并选取同期在榆林市第二医院体检正常的63例女性志愿者为对照组。比较各组一般资料;采用酶联免疫吸附法(ELISA)检测三组受试者血浆中APC、PC水平;Pearson相关系数分析RSA并发APS患者血浆中APC水平与PC水平的相关性;采用受试者工作特征 (ROC) 曲线评价血浆中APC、PC水平对RSA合并APS的预测价值。【结果】RSA并发APS组患者血浆中APC、PC水平及雌二醇(E₂)水平均低于单纯RSA组、对照组,单纯RSA组患者血浆中APC、PC水平均低于对照组(P<0.05);RSA并发APS患者血浆APC水平与PC水平呈正相关(r=0.466,P<0.05);血浆中APC、PC水平预测RSA并发APS的曲线下面积(AUC)分别为0.854、0.837,截断值分别为2520.63 ng/L、2.93 μg/mL,敏感度分别为81.7%、85.0%,特异度分别为81.2%、72.4%;两者联合诊断RSA并发APS的AUC为0.907,敏感度、特异度分别为80.0%、90.2%。【结论】RSA并发APS患者血浆中APC、PC水平均明显降低,两者联合可有效提高对RSA并发APS的诊断效能,有助于临床预测APS是否并发RSA。

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	李蓉
	申冰清

关键词 ：流产,习惯性, 抗磷脂综合征, 蛋白质C

Abstract：【Objective】To investigate the expression and clinical significance of activated protein C (APC) and protein C (PC) in plasma of patients with recurrent abortion (RSA) complicated with antiphospholipid syndrome (APS). 【Methods】A total of 123 patients with RSA diagnosed and treated in the Yulin No.2 Hospital from August 2017 to January 2020 were selected and divided into simple RSA group (63 cases) and RSA complicated with APS group (60 cases) according to whether the patients were combined with APS. 63 female volunteers who had normal physical examination in the same hospital in the same period were selected as the control group.The general data of each group was compared;the levels of APC and PC in plasma were detected by enzyme linked immunosorbent assay (ELISA); Pearson correlation coefficient was used to analyze the correlation between plasma APC level and PC level in RSA patients with APS; Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of APC and PC levels in plasma for RSA combined with APS. 【Results】The plasma levels of APC,PC and estradiol (E₂) in RSA complicated with APS group were lower than those in the RSA group and the control group. The plasma levels of APC and PC in the RSA group were lower than those in the control group (P<0.05); There was a positive correlation between plasma APC level and PC level in RSA patients with APS (r=0.466,P<0.05); The area under curve (AUC) of plasma APC and PC levels in predicting RSA complicated with APS were 0.854 and 0.837 respectively.The cut-off values are 2520.63 ng/L and 2.93 μg/mL respectively. The sensitivity was 81.7% and 85.0% respectively and the specificity was 81.2% and 72.4% respectively; The AUC of combined diagnosis of RSA and APS was 0.907,the sensitivity and specificity were 80.0% and 90.2% respectively. 【Conclusion】 The plasma levels of APC and PC in patients with RSA complicated with APS were significantly decreased. The combination of the two can effectively improve the diagnostic efficiency of RSA complicated with APS,and help to predict whether APS complicated with RSA.

Key words： Abortion, Habitual Antiphospholipid Syndrome Protein C

收稿日期: 2021-12-13

中图分类号:

R714.21

通讯作者: *E-mail:577384629@qq.com

引用本文:

李蓉, 申冰清. 活化蛋白C、蛋白C在复发性流产合并抗磷脂综合征患者血浆中的表达水平及其临床意义[J]. 医学临床研究, 2022, 39(6): 855-858.
LI Rong, SHEN Bing-qing. Expression of Activated Protein C and Protein C in Plasma of Patients with Recurrent Abortion Complicated with Antiphospholipid Syndrome and its Clinical Significance. JOURNAL OF CLINICAL RESEARCH, 2022, 39(6): 855-858.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.06.015 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I6/855

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