关键词: 先兆早产, 自身抗体, 相关性, 预测

Abstract:

Objective To investigate the correlation between serum levels of antiphospholipid antibody （aPL） （ACA-IgG， ACA-IgM， β2-GPI-IgG， β2-GPI-IgM）， LAC， ds-DNA， and ANA and preterm labor with prematurity， and to analyze the prediction of preterm labor with the combination of age， week of gestation， history of delivery， and history of miscarriage， so as to provide references for the prevention and treatment of preterm labor and to promote eugenics. Methods Through a retrospective study design， 43 pregnant women with preterm labor with preeclampsia diagnosed and treated at Guangdong Provincial People's Hospital from June 2018 to December 2020 were collected as a case group， and 47 healthy pregnant women of the same period and similar gestational age were randomly selected as a control group. aPL （ACA-IgG， ACA-IgM， β2-GPI-IgG， β2-GPI-IgM） and ds-DNA were detected by enzyme immunoassay （ELISA） using an enzyme immunoassay instrument， lupus anticoagulant （LAC） in plasma was detected by coagulometer， and ANA was detected by indirect immunofluorescence using an immunofluorescence analyzer， and the application of SPSS 24.0 software was used to statistically analyze the general information and laboratory test data. the age of the patients was combined， gestational week， birth history， miscarriage history and other general information， logistic regression analysis was performed to find the independent influencing factors related to preterm labor； the analysis was performed by using the subjects' work characteristic curve （ROC curve） to determine the area under the ROC curve （AUC）， the best predictive value， sensitivity and specificity， and to analyze the predictive value of preterm labor with preterm labor. Results In this study， the pregnant women in the group of pregnant women with preterm labor with preeclampsia were aged 27 ~ 40 years， with a mean age of （29.93 ± 3.91） years， and the gestational weeks at the time of blood collection were 27-36 weeks， with a mean gestational week of （31.96 ± 2.35） weeks， while the pregnant women in the healthy control group during the same time period were aged 25 ~ 40 years， with a mean age of （30.74 ± 3.44） years， and the gestational weeks at the time of blood collection were 28 ~ 36 weeks， with a mean gestational week of （32.84 ± 2.13） weeks. In the same period， healthy control group pregnant women were aged 25 ~ 40 years， with a mean age of （30.74 ± 3.44） years， and were 28 ~ 36 weeks pregnant at the time of blood collection. The β2-GPI-IgM level of pregnant women in the case group with preterm labor was significantly higher than that of pregnant women in the healthy control group at the same time， with statistically significant differences （P < 0.05）， while the differences in the levels of β2-GPI-IgG， ds-DNA， and LAC between the two groups were not statistically significant （P > 0.05）.The analysis of the ROC curves showed that the AUC of β2-GPI-IgM was 0.642 （P < 0.05）， which was the highest in the preterm group， and the AUC was 0.642 （P < 0.05）. 0.05）， which was an independent influencing factor of preterm labor； age， gestational week， labor history， and miscarriage history could not be used as independent influencing factors of preterm labor. Conclusion β2-GPI-IgM is associated with threatened preterm labor，it can be used as a predictor of threatened preterm labor，and has clinical utility in the monitoring of threatened preterm labor in pregnant women.

Key words: threatened preterm labor, autoantibodies, correlation, prediction