北京大学学报（医学版）2023，Vol.55Issue(6)：1039-1044,6.DOI:10.19723/j.issn.1671-167X.2023.06.013
抗内皮细胞抗体检测在早期流产中的预测价值
Anti-endothelial cell antibodies in predicting early miscarriage
摘要
Abstract
Objective:To explore the clinical significance of anti-endothelial cell antibodies(AECA)in predicting early miscarriage.Methods:A total of 122 pregnant women with no history of autoimmune diseases who underwent prenatal examination at Peking University People's Hospital from January 2020 to December 2022 were selected,and they were tested for AECA.Based on the history of early miscar-riage(gestational age at miscarriage＜12 weeks),the participants were divided into an early miscarriage group and a control group.t-tests,non-parametric Wilcoxon tests,Chi-square tests,and Fisher's exact probability method were used to compare general information and laboratory indicators between the two groups.A multivariate Logistic regression model was used to analyze the factors associated with early mis-carriage.The natural miscarriage rates were assessed through follow-up with pregnant women,and Kaplan-Meier survival analysis was employed to compare the natural miscarriage rates between AECA-positive and AECA-negative pregnant women.Results:(1)A total of 122 pregnant women were en-rolled,comprising 35 cases(28.7％)in the early miscarriage group,with an average age of(32.1± 6.1)years,and 87 cases(71.3％)in the control group,with an average age of(30.7±5.1)years.The early miscarriage group had higher gravidity[3(2,4)vs.1(1,2),Z=-6.402,P＜0.001]and a higher prevalence of hypertension(11.4％vs.1.1％,P=0.024).The positive rate of AECA in the early miscarriage group(34.3％vs.8.0％,x2=13.070,P＜0.001)and the proportion of elevated immunoglobulin G(17.1％vs.4.6％,P=0.032)were significantly higher than that in the control group.(2)Multivariate logistic regression analysis showed that higher gravidity(OR=4.149,95％CI:2.287-7.529,P＜0.001),AECA positivity(OR=4.288,95％CI:1.157-15.893,P=0.029),and elevated immunoglobulin G levels(OR=6.177,95％CI:1.156-33.015,P=0.033)were risk factors for early miscarriage.(3)The 122 pregnant women were categorized into two groups:the AECA-positive group(19 cases)and the AECA-negative group(103 cases).Survival analysis demonstrated that at the end of 12 weeks of gestation,the fetal survival rate in the AECA-positive group was significant-ly lower than that in the AECA-negative group(84.2％vs.96.1％,P=0.035).Conclusion:Higher gravidity,AECA positivity,and elevated immunoglobulin G levels are significant risk factors for early miscarriage.The results demonstrate that AECA is a novel predicting test in early miscarriage.关键词
抗内皮细胞抗体/早期流产/危险因素Key words
Anti-endothelial cell antibodies/Early miscarriage/Risk factors分类
医药卫生引用本文复制引用
罗靓,李云,王红彦,相晓红,赵静,孙峰,张晓盈,贾汝琳,李春..抗内皮细胞抗体检测在早期流产中的预测价值[J].北京大学学报（医学版）,2023,55(6):1039-1044,6.基金项目
中华国际医学交流基金会(Z-2018-40-2101)和北京大学人民医院研究与发展基金(RD 2022-66)Supported by the China Inter-national Medical Foundation(Z-2018-40-2101)and Peking University People's Hospital Scientific Research Development Funds(RD 2022-66) （Z-2018-40-2101）
