血清TIMP-1、VEGF水平对自然分娩初产妇产后压力性尿失禁严重程度的预测价值OACSTPCD

Objective To investigate the predictive value of serum tissue inhibitor of matrix metalloproteinase-1(TIMP-1)and vascular endothelial growth factor(VEGF)levels in postpartum stress urinary incontinence(PSUI)of primiparae undergoing natural delivery.Methods In total,220 primiparae with PSUI undergoing natural delivery from December 2019 to July 2023 were selected as the case group,and were divided into mild group(n=158)and moderate to severe group(n=62)ac-cording to the results of urine pad test.In addition,220 primiparae without PSUI undergoing natural delivery were included as control group.Serum TIMP-1 and VEGF levels were detected by ELISA.The correlation between serum TIMP-1 and VEGF in PSUI patients was analyzed by Pearson method.Multivariate Logistic regression was used to analyze the influencing factors of disease severity in PSUI patients.The predictive value of serum TIMP-1 and VEGF for disease severity in PSUI patients was analyzed by receiver operating characteristic(ROC)curve.Results The serum TIMP-1 level in the case group was significant-ly lower than that in the control group,while the serum VEGF level was significantly higher than that in the control group(P<0.01).Serum TIMP-1 level in moderate to severe group was significantly lower than that in mild group,while serum VEGF lev-el,proportion of patients aged≥35 years and newborn body weight were significantly higher than those in mild group(P<0.05,P<0.01).Serum TIMP-1 in PSUI patients was negatively correlated with VEGF(r=-0.671,P<0.05).TIMP-1 was a protec-tive factor for aggravation of disease severity in PSUI patients(P<0.01),and VEGF was a risk factor for aggravation of disease severity in PSUI patients(P<0.01).The area under the ROC curve(AUC)of TIMP-1 and VEGF alone and in combination for predicting the disease severity of PSUI patients was 0.857,0.808 and 0.901,respectively,and the AUC of combination of the two in the prediction was higher than that predicted by TIMP-1 and VEGF alone(P<0.01).Conclusion In PSUI patients,se-rum TIMP-1 expression is low,VEGF expression is high,and TIMP-1 and VEGF are closely related to the severity of the dis-ease.The combination of the two has high value in predicting the severity of the disease in PSUI patients.