广西医学

目的探讨孕中期子宫血流参数联合血清糖类抗原125（CA125）水平、血清信号传导和转录激活因子4（STAT4）水平对子痫前期患者妊娠结局的评估价值。方法选取127例子痫前期患者作为研究对象，根据妊娠结局将其分为结局不良组（32例）和结局良好组（95例）。比较两组患者的临床资料，以及孕20~25周时的子宫血流参数［子宫动脉阻力指数（RI）、子宫动脉搏动指数（PI）］、血清CA125水平、血清STAT4水平。采用多因素Logistic回归模型分析子痫前期患者妊娠结局的影响因素。采用受试者工作特征曲线分析子宫动脉RI、子宫动脉PI、血清CA125水平、血清STAT4水平单独及联合预测对子痫前期患者妊娠结局的价值。结果子痫前期患者妊娠结局不良发生率为25.19%（32/127）。结局不良组患者的子宫动脉RI、子宫动脉PI、血清CA125水平、血清STAT4水平、子痫前期重度患者比例、甲胎蛋白水平高于结局良好组（P＜0.05）。子宫动脉RI、子宫动脉PI、血清CA125水平、血清STAT4水平升高是子痫前期患者妊娠结局不良的危险因素（P＜0.05）。子宫动脉RI、子宫动脉PI、血清CA125水平、血清STAT4水平单独及联合预测子痫前期患者妊娠结局的曲线下面积分别为0.836、0.812、0.813、0.785、0.978，四者联合预测的曲线下面积高于四者单独预测的曲线下面积（P＜0.05）。结论孕中期子宫动脉RI、子宫动脉PI、血清CA125水平、血清STAT4水平升高均为子痫前期患者妊娠结局不良的危险因素，且四者联合评估对子痫前期患者妊娠结局的预测效能较高。

ObjectiveTo investigate the estimated value of uterine blood flow parameters combine with serum carbohydrate antigen 125 (CA125) level and serum signal transducer and activator of transcription 4 (STAT4) level in the second trimester of pregnancy on pregnancy outcome in patients with preeclampsia. MethodsA total of 127 patients with preeclampsia were selected as the research subjects, and they were divided into adverse outcome group (32 cases) or favorable outcome group (95 cases) according to pregnancy outcome. The clinical data, uterine blood flow parameters in terms of uterine arterial resistance index (RI), uterine arterial pulsation index (PI), and serum CA125 and STAT4 levels from 20 to 25 weeks of pregnancy were compared between patients of the two groups. The multivariate Logistic regression model was used to analyze the influencing factors for pregnancy outcome in patients with preeclampsia. The value of uterine arterial RI and PI, and serum CA125 and STAT4 levels for single and combined prediction on pregnancy outcome in patients with preeclampsia was analyzed by using the receiver operating characteristic curve. ResultsThe incidence rate of adverse pregnancy outcome in preeclampsia patients was 25.19% (32/127). The adverse outcome group exhibited higher uterine arterial RI and PI, higher serum CA125 and STAT4 levels, and a higher proportion of patients with severe preeclampsia, as well as a higher alpha fetoprotein level as compared with the favorable outcome group (P＜0.05). The elevations of uterine arterial RI and PI, serum CA125 level, and serum STAT4 level were the risk factors for adverse pregnancy outcome in patients with preeclampsia (P＜0.05). The areas under the curve of uterine arterial RI and PI, serum CA125 level, serum STAT4 level for single and combined prediction on pregnancy outcome in patients with preeclampsia were 0.836, 0.812, 0.813, 0.785, and 0.978, respectively, and the area under the curve of the four combined prediction was higher than that of the four for single prediction (P＜0.05). ConclusionThe elevations of uterine arterial RI and PI, serum CA125 level, and serum STAT4 level in the second trimester of pregnancy are all risk factors for adverse pregnancy outcome in patients with preeclampsia, and the combined evaluation of the four indices exerts a relatively high predictive efficiency for pregnancy outcome in patients with preeclampsia.