血清SIL-2R、HCY与妊娠期亚临床甲状腺功能减退症及其妊娠结局的关系分析

Analysis of the Relationship between Serum SIL-2R, HCY and Subclinical Hypothyroidism during Pregnancy and Pregnancy Outcome

摘要: 目的：分析妊娠期亚临床甲状腺功能减退症(SCH)孕妇血清可溶性白细胞介素-2受体(SIL-2R)、同型半胱氨酸(HCY)的表达意义及与妊娠结局的关系。方法：选择我院自2021年1月至2023年6月收治的120例妊娠期SCH孕妇(观察组)及120例正常妊娠孕妇(对照组)；检测两组血清SIL-2R、HCY表达水平，分析血清SIL-2R、HCY与促甲状腺激素(TSH)的关系，通过受试者工作特征曲线(ROC)下面积(AUC)评价观察组血清SIL-2R联合HCY对妊娠结局不良的预测效能。结果：观察组妊娠期碘摄入量偏少比例、TPOAb阳性率和TGAb阳性率均高于对照组，差异均有统计学意义(P < 0.05)；观察组血清SIL-2R、HCY表达水平均高于对照组，差异均有统计学意义(P < 0.05)；经Pearson相关性分析，妊娠期SCH孕妇血清SIL-2R、HCY表达水平与TSH呈正相关(P < 0.05)；经Logistic回归分析，妊娠期碘摄入偏少、血清SIL-2R和HCY高水平表达均是妊娠期SCH的独立影响因素(P < 0.05)；妊娠结局不良组血清SIL-2R、HCY表达水平均高于妊娠结局正常组，差异均有统计学意义(P < 0.05)；经ROC曲线分析，血清SIL-2R联合HCY预测妊娠期SCH孕妇妊娠结局不良的特异度为62.81%，敏感度为88.69%，AUC为0.931。结论：血清SIL-2R、HCY表达水平升高与妊娠期SCH发生密切相关，两者联合预测孕妇妊娠结局不良的效能较好，值得临床予以重视应用。

Abstract: Objective: To analyze the expression significance of serum soluble interleukin-2 receptor (SIL-2R) and homocysteine (HCY) in pregnant women with subclinical hypothyroidism (SCH) during pregnancy and their relationship with pregnancy outcome. Methods: 120 SCH pregnant women (observation group) and 120 normal pregnant women (control group) admitted to our hospital from January 2021 to June 2023 were selected. The expression levels of serum SIL-2R and HCY in the two groups were detected, and the relationship between serum SIL-2R and HCY and thyroid stimulating hormone (TSH) was analyzed. The predictive efficacy of serum SIL-2R combined with HCY in the observation group was evaluated by area under receiver operating characteristic curve (ROC) (AUC). Results: The proportion of low iodine intake, TPOAb positive rate and TGAb positive rate in the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). The expression levels of serum SIL-2R and HCY in observation group were higher than those in control group, and the differences were statistically significant (P < 0.05). By Pearson correlation analysis, serum SIL-2R and HCY expression levels of SCH pregnant women were positively correlated with TSH (P < 0.05). Logistic regression analysis showed that low iodine intake and high levels of serum SIL-2R and HCY were independent influencing factors of SCH during pregnancy (P < 0.05). The levels of serum SIL-2R and HCY in the adverse pregnancy outcome group were higher than those in the normal pregnancy outcome group, with statistical significance (P < 0.05). ROC curve analysis showed that the specificity, sensitivity and AUC of serum SIL-2R combined with HCY in predicting adverse pregnancy outcomes of SCH pregnant women were 62.81%, 88.69% and 0.931 respectively. Conclusion: The increase of serum SIL-2R and HCY expression levels is closely related to the occurrence of SCH during pregnancy, and the combination of the two can predict the adverse pregnancy outcome of pregnant women, which is worthy of clinical attention.