孕中期肌酸激酶、血管内皮生长因子与瘢痕子宫孕妇发生胎盘植入性疾病的关系及对胎盘植入程度的预测研究.pdf
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1、临床和实验医学杂志2 0 2 3年8 月第2 2 卷第15期samide in a patient with ring chromosome 20 syndrome J.Brain Dev,2020,42(6):473-476.11张鹤声,张恩惠,刘文钰,等拉考沙胺单药治疗癫痫发作的研究进展J中国新药与临床杂志,2 0 2 2,41(2):7 9-8 4.12 Yamamoto Y,Terada K,Araki Y,et al.Therapeutic monitoring of la-cosamide in Japanese patients with epilepsy:clinical re
2、sponse,tolerabili-ty,and optimal therapeutic rangeJ.Ther Drug Monit,2020,42(5):754-759.13 Fukuyama K,Ueda Y,Okada M.Effects of carbamazepine,lacosamideand zonisamide on gliotransmitter release associated with activated astro-glial hemichannelsJ.Pharmaceuticals,2020,13(6):117.14 Winkler J,Schoemaker
3、R,Stockis A.Population pharmacokinetics of1639adjunctive lacosamide in pediatric patients with epilepsy J.J ClinPharmacol,2019,59(4):541-547.【15】张润春,王玉珍,张静,等.拉考沙胺联合奥卡西平对难治性癫痫患儿神经递质、发作频次的影响J疑难病杂志,2 0 2 2,2 1(3):272-276.【16 袁振宇,薛国芳癫痫后小胶质细胞与炎症的关系及研究进展J.中华老年心脑血管病杂志,2 0 2 0,2 2(10):1113-1115.17 Druzhkova
4、 TA,Yakovlev AA,Rider FK,et al.Elevated Serum CortisolLevels in Patients with Focal Epilepsy,Depression,and Comorbid Epi-lepsy and DepressionJ.Int J Mol Sci,2022,23(18):10414.(收稿日期:2 0 2 3-0 3-12)D0I:10.3969/j.issn.1671-4695.2023.15.019孕中期肌酸激酶、血管内皮生长因子与瘢痕子宫孕妇发生胎盘植入性疾病的关系及对胎盘植入程度的预测研究涂业秀李燕燕苏艳洁唐哲文邓新琼!
5、(1柳州市妇幼保健院产科广西柳州5450 0 1;2 广西妇产疾病临床医学研究中心广西柳州5450 0 1)【摘要】目的探讨孕中期肌酸激酶(CK)、血管内皮生长因子(VEGF)与瘢痕子宫孕妇发生胎盘植入性疾病的关系及对胎盘植入程度的预测价值。方法回顾性选取2 0 19 年7 月至2 0 2 2 年7 月柳州市妇幼保健院收治的7 0 例瘢痕子宫伴胎盘植入性疾病孕妇作为观察组,其中粘连型52 例,植入型或穿透型18 例;另选7 0 例瘢痕子宫不伴胎盘植入性疾病孕妇作为对照组。比较两组孕中期CK、V EG F表达水平;采用多因素Logistic回归分析分析瘢痕子宫孕妇发生胎盘植入性疾病的独立预测因素
6、;采用受试者工作特征(ROC)曲线分析孕中期CK联合VEGF对瘢痕子宫孕妇发生胎盘植入性疾病的预测效能;分析孕中期CK、V EG F在不同胎盘植入程度孕妇中的差异性;采用Pearson相关性分析分析孕中期CK、V EG F与胎盘植入超声评分量表评分的关系。结果观察组孕中期CK、V EC F水平分别为(138.42 2 5.6 9)U/L、(19 8.42 46.13)p g/m L,均高于对照组(7 2.32 10.48)U/L、(12 1.2 32 3.47)p g/m L,差异均有统计学意义(P0.05)。经多因素Logistic回归分析,孕中期CK、V EG F均是瘢痕子宫孕妇发生胎盘植
7、入性疾病的独立预测因素(OR=2.562,95.0%CI:1.4416.059;0R=0.356,95.0%CI:0.1280.832;P 0.0 5)。经R0C曲线分析,孕中期CK联合VEGF预测瘢痕子宫孕妇发生胎盘植入性疾病的曲线下面积(AUC)为0.90 3。在观察组7 0 例瘢痕子宫伴胎盘植入性疾病孕妇中,植入型或穿透型孕妇孕中期CK、VECF水平分别为(157.8 436.7 2)U/L、(2 53.16 58.7 4)Pg/m L,均高于粘连型(112.4318.7 4)U/L、(154.7 535.8 1)p g/mL,差异均有统计学意义(P0.05)。经Pearson相关性分析
8、,瘢痕子宫伴胎盘植入性疾病孕妇孕中期CK、VEG F水平与胎盘植入超声评分量表评分均呈正相关(P0.05)。结论孕中期CK联合VEGF预测瘢痕子宫孕妇发生胎盘植入性疾病的效能较好,有助于评估胎盘植入程度。【关键词】胎盘疾病肌酸激酶血管内皮生长因子类瘢痕子宫胎盘植入程度Relationship between creatine kinase,vascular endothelial growth factor and placental accretion in pregnant women with cicatricial ute-rus and the prediction of place
9、ntal accretion degree.TU Ye-xiu,LI Yan-yan,SU Yan-jie,et al.Department of Obstetrics,Liuzhou Mater-nity and Child Healthcare Hospital,Liuzhou Guangxi 545001,China.Abstract)Objective To investigate the relationship between creatine kinase(CK),vascular endothelial growth factor(VEGF)and pla-cental acc
10、retion in pregnant women with cicatricial uterus and the predictive value of placental accretion degree.MethodsFrom July 2019 to July2022,70 pregnant women with cicatricial uterus and placenta accreta admitted to Liuzhou Maternal and Child Health Hospital were retrospectivelyselected as the observat
11、ion group,52 cases of adhesive type,18 cases of implanted or penetrating type;and another 70 pregnant women with cica-tricial uterus without placenta accreta were selected as the control group.The expression levels of CK and VEGF in the second trimester were com-pared between the two groups.Multivar
12、iate Logistic regression was used to analyze the independent predictors of placental accreta in pregnantwomen with scar uterus.The predictive efficacy of CK combined with VEGF in the prediction of placental accreta in pregnant women with scar ute-基金项目:广西壮族自治区科学技术厅科技计划项目(编号:桂科AD22035223);广西壮族自治区科学技术厅
13、重点研发计划项目(编号:桂科AB18126056)*通讯作者:邓新琼,E-mail:文章编号:16 7 1-46 9 5(2 0 2 3)15-16 39-0 4:1640:rus was analyzed by receiver operating characteristic(ROC)curve.The differences of CK and VEGF in pregnant women with different placentalimplantation degrees in the second trimester were analyzed,and Pearson corre
14、lation was used to analyze the relationship between CK,VEGF andplacental implantation ultrasound score scale in the second trimester.Results The levels of CK and VEGF in the observation group during thesecond trimester were(138.42 25.69)U/L,(198.42 46.13)pg/mL,respectively,which were higher than tho
15、se in the control group(72.3210.48)U/L,(121.23 23.47)pg/mL,the differences were statistically significant(P 0.05).Multiple Logistic regression analysisshowed that CK and VEGF in the second trimester were independent predictors of placental accretion disease in pregnant women with cicatricial u-terus
16、(0R=2.562,95.0%CI:1.441-6.059;0R=0.356,95.0%CI:0.128-0.832;P 0.05).According to R0C curve analysis,the area under the curve(AUC)of CK combined with VEGF in predicting placental accreta disease in pregnant women with scar uterus was 0.903.In the observation group of 70 pregnant women with cicatricial
17、 uterus and placental accretion disease,the levels of CK and VEGF in implant orpenetration women during the second trimester were(157.84 36.72)U/L,(253.16 58.74)pg/mL,respectively,which were higher than inadhesion women(112.43 18.74)U/L,(154.75 35.81)pg/mL,the differences were statistically signific
18、ant(P 0.05).According toPearson correlation analysis,there was a positive correlation between the levels of CK and VEGF and the score of placental accretion ultrasoundscale in the second trimester of pregnant women with cicatricial uterus and placental accretion disease(P 0.05),具有可比性。本研究获柳州市妇幼保健院伦理委
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- 中期 肌酸激酶 血管 内皮 生长因子 瘢痕 子宫 孕妇 发生 胎盘 植入 性疾病 关系 程度 预测 研究
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