新疆医科大学学报

目的 探讨复发性流产(Recurrent spontaneous abortion, RSA)患者血清抗核抗体(Antinuclear antibody, ANA)、血浆蛋白C变化及对保胎结局的预测价值。方法 选取2019年1月-2022年3月河北省生殖健康医院收治的RSA患者128例为观察组，选取同期健康孕妇64例为对照组。两组均检测血清ANA、血浆蛋白C水平，观察两组保胎成功、保胎失败情况。分析血清ANA、血浆蛋白C水平与保胎失败的独立关系及二者对保胎结局的预测价值。结果 观察组血清ANA水平高于对照组，血浆蛋白C水平低于对照组(P<0.05)。观察组128例患者保胎成功率为67.97%(87/128),保胎失败率为32.03%(41/128)。Logsitic回归模型分析发现：在无调整因素条件下，血清ANA、血浆蛋白C水平高表达患者保胎失败风险分别是ANA、蛋白C低表达者的2.437倍、0.726倍(P<0.05);调整月经失调、流产次数、保胎时间条件下，ANA、蛋白C高表达患者保胎失败风险分别是ANA、蛋白C低表达者的2.825倍、0.399倍(P<0.05);调整月经失调、流产次数、保胎时间、空腹血糖受损、自身免疫异常条件下，ANA、蛋白C高表达患者保胎失败风险分别是ANA、蛋白C低表达者3.294倍、0.363倍(P<0.05)。ANA、蛋白C水平联合评估RSA患者保胎结局的曲线下面积(Area under curve,AUC)高于二者单独评估的AUC(Z/P=3.426/0.001,2.245/0.025)。结论 RSA患者血清ANA水平升高，血浆蛋白C降低，且是保胎失败的独立影响因素，可为临床评估保胎结局提供参考。

Objective To investigate the changes of serum antinuclear antibody(ANA) and plasmaprotein C in patients with recurrent spontaneous abortion(RSA) and their predictive value for abortion saving outcome. Methods 128 RSA patients from the hospital from January 2019 to March 2022 were selected as observation group, and 64 healthy pregnant women from the same period were selected as control group. Both groups were tested for serum ANA and plasmaprotein C levels. Statistics on the success and failure of abortion in the observation group. Analyze the independent relationship between serum ANA and plasmaprotein C levels and fetal failure, as well as their predictive value for fetal outcomes. Results The serum ANA level in the observation group was higher than that in the control group, while the plasmaprotein C level was lower than that in the control group(P<0.05). The success rate of abortion in the observation group of 128 patients was 67.97%(87/128), and the failure rate of abortion was 32.03%(41/128). The Logstic regression model analysis found that under the condition of no adjustment factors, thepatients with high expression of serum ANA and plasmaprotein C levels had a 2.437 and 0.726 fold higher risk of fetal failure compared to those with low expression of ANA and protein C, respectively(P<0.05). Under the conditions of adjusting for menstrual disorders, miscarriage frequency, and gestational protection time, the patients with high expression of ANA and protein C had a 2.825 and 0.399 fold higher risk of gestational failure compared to those with low expression of ANA and protein C, respectively(P<0.05). Under the conditions of adjusting for menstrual disorders, miscarriage frequency, gestational protection time, impaired fasting blood glucose, and autoimmune abnormalities, thepatients with high expression of ANA and protein C have a 3.294 and 0.363 fold higher risk of gestational failure compared to those with low expression of ANA and protein C, respectively(P<0.05). The area under curve(AUC) value of the combination of ANA and protein C in RSA patients was higher than that of the two alone(Z/P=3.426/0.001, 2.245/0.025). Conclusion Serum ANA level was increased, and plasmaprotein C levelwas decreased in RSA patients, which is an independent influencing factor of abortion saving outcome, and can provide reference for clinical evaluation of prognosis.