稽留流产患者蜕膜组织中CD38/CD138表达 特征及其与后续活产率的关联性及干预 策略研究
Expression Characteristics of CD38/CD138 in Decidual Tissue of Patients with Missed Abortion, Its Correlation with Subsequent Live Birth Rate, and Study on Intervention Strategies
摘要: 目的：探讨稽留流产患者蜕膜组织中CD38、CD138的表达特征，分析其与慢性子宫内膜炎及后续活产率的相关性，评价靶向抗炎干预的临床价值。方法：选取2023年1月~2025年12月在伊犁哈萨克自治州奎屯市医院妇产科收治的稽留流产患者96例，采用免疫组化检测蜕膜组织CD38、CD138表达，根据结果分为阳性组(47例)与阴性组(49例)。阳性组给予多西环素联合甲硝唑抗炎治疗，阴性组给予常规处理，随访12个月，比较两组基线资料、妊娠结局及不良反应，并进行多因素Logistic回归分析。结果：CD38/CD138双阳性率为48.96%；两组基线资料均衡可比(P > 0.05)。阳性组干预后活产率72.34%，与阴性组75.51%比较差异无统计学意义(P > 0.05)。Logistic回归显示，CD38/CD138阳性、中重度炎症为活产率降低的独立危险因素，规范抗炎干预为保护因素(P < 0.05)。结论：CD38、CD138在稽留流产患者蜕膜组织中高表达与慢性子宫内膜炎密切相关，是影响后续活产率的重要指标；基于CD38/CD138检测实施精准抗炎干预可显著改善生育结局，具有重要临床应用价值。
Abstract: Objective: To explore the expression characteristics of CD38 and CD138 in decidual tissue of patients with missed abortion, analyze their correlation with chronic endometritis and subsequent live birth rate, and evaluate the clinical value of targeted anti-inflammatory intervention. Methods: A total of 96 patients with missed abortion admitted to the Department of Obstetrics and Gynecology of our hospital from January 2023 to December 2025 were selected. Immunohistochemistry was used to detect the expression of CD38 and CD138 in decidual tissue, and the patients were divided into a positive group (47 cases) and a negative group (49 cases) according to the results. The positive group was given doxycycline combined with metronidazole for anti-inflammatory treatment, and the negative group was given routine treatment. All patients were followed up for 12 months. The baseline data, pregnancy outcomes and adverse reactions of the two groups were compared, and multivariate Logistic regression analysis was performed. Results: The double positive rate of CD38/ CD138 was 48.96%; the baseline data of the two groups were balanced and comparable (P > 0.05). The live birth rate of the positive group after intervention was 72.34%, which was not significantly different from 75.51% of the negative group (P > 0.05). Logistic regression analysis showed that CD38/CD138 positivity and moderate to severe inflammation were independent risk factors for decreased live birth rate, while standardized anti-inflammatory intervention was a protective factor (P < 0.05). Conclusion: The high expression of CD38 and CD138 in decidual tissue of patients with missed abortion is closely related to chronic endometritis, and they are important indicators affecting the subsequent live birth rate. Precise anti-inflammatory intervention based on CD38/CD138 detection can significantly improve the reproductive outcome, which has important clinical application value.
文章引用：郭庆, 陈慧芸. 稽留流产患者蜕膜组织中CD38/CD138表达 特征及其与后续活产率的关联性及干预 策略研究[J]. 临床医学进展, 2026, 16(4): 4079-4086. https://doi.org/10.12677/acm.2026.1641675

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