1. 妊娠期肝内胆汁淤积症患者血清 ATX、Melatonin 与炎症标志物 和妊娠结局的关系.
- Author
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夏美艳, 黄亚雄, 曹文雅, 李 侠, 张 敏, and 张 强
- Subjects
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PREGNANCY outcomes , *LEUCOCYTES , *RECEIVER operating characteristic curves , *LOGISTIC regression analysis , *DISEASE risk factors - Abstract
Objective: To investigate the relationship between serum autocrine motility factor (ATX), melatonin (MT) and inflammatory markers and pregnancy outcome in patients with intrahepatic cholestasis of pregnancy (ICP). Methods: 120 ICP patients admitted to Chinese Medicine Dongfeng General Hospital Affiliated to Hubei Medical College from January 2021 to January 2023 were selected as ICP group. ICP patients were divided into mild group (78 cases) and severe group (42 cases) according to the severity of the patient’s condition, and ICP patients were divided into good outcome group (79 cases) and poor outcome group (41 cases) according to the pregnancy outcome, another 120 healthy pregnant women were selected as control group. The differences of ATX, MT and inflammatory markers [white blood cells (WBC), neutrophils/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR)] in serum of each group were detected and compared. The correlation between SATX, MT and serum inflammatory markers in ICP patients was analyzed by Pearson, the independent risk factors for poor pregnancy outcomes in ICP patients were analyzed by multivariate Logistic regression, the predictive value of serum ATX and MT for poor pregnancy outcomes in ICP patients was analyzed by receiver operating characteristic (ROC) curve. Results: Compared with control group, serum ATX, WBC and NLR in ICP group were significantly increased, and MT and PLR were significantly decreased (P<0.05). Compared with mild group, serum ATX, WBC and NLR in severe group were significantly increased, while MT and PLR were significantly decreased (P<0.05). Serum ATX in ICP group was positively correlated with WBC and NLR, and negatively correlated with PLR (P<0.05). MT was negatively correlated with WBC and NLR, and positively correlated with PLR (P<0.05). Compared with good outcome group, the serum ATX and NLR in poor outcome group were increased, and the serum MT and PLR were significantly decreased (P<0.05). Multivariate Logistic regression analysis showed that, ATX and total bile acid levels increased, MT level decreased and severe ICP were risk factors for poor pregnancy outcome in ICP patients (P<0.05). ROC curve analysis showed that, the area under the curve (AUC) of ATX, MT combined with ICP grading in predicting poor pregnancy outcome in ICP patients was 0.808, which was higher than that predicted by single index. Conclusion: The increase of serum ATX level and the decrease of MT level in ICP patients are risk factors for poor pregnancy outcome, which are significantly correlate with inflammatory markers. ATX and MT combine with ICP grading have high predictive value for poor pregnancy outcome in ICP patients. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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