全身炎症指标对子宫颈环扎术后妊娠结局预测价值的研究OA
Study on the predictive value of systemic inflammatory markers for pregnancy outcomes after cervical cerclage
目的:探讨术前全身炎症指标对宫颈环扎术后妊娠结局的预测价值.方法:选取2022 年1 月1 日至2025 年10 月30 日在北京市海淀区妇幼保健院接受宫颈环扎术并分娩的124 例单胎孕妇,按环扎适应证分为三组:病史指征组 35 例、超声指征组66 例、体格检查指征组23 例.根据孕妇外周血计算炎症标志物(SⅡ、SIRI、NMR、PLR、NLR、MLR),比较其在不同环扎适应证组孕妇中的分布情况,通过相关性分析评估炎症标志物与妊娠结局的关系,并对具有显著相关性的炎症标志物,进一步采用 ROC 曲线分析评估其预测价值.结果:3 组孕妇在 S Ⅱ、SIRI、PLR、NLR、MLR 方面存在显著差异(P<0.05),体格检查指征组的上述指标均显著高于其他两组,环扎失败率、34 周前分娩率显著高于其他两组(P<0.05),新生儿出生体重、1min Apgar 评分更低,NICU 转入率更高,环扎至分娩间隔时间最短.相关性分析显示,SⅡ、SIRI、NLR 与分娩孕周、新生儿出生体重、1min Apgar 评分、环扎至分娩间隔时间呈显著负相关(P<0.05).ROC 曲线分析显示,SⅡ、SIRI、NLR 对孕34 周前分娩、新生儿低出生体重方面均有统计学意义的预测价值(P<0.05).结论:SⅡ、SIRI、NLR 水平是预测宫颈环扎术结局及妊娠结局的重要生化标志物,可作为无创预测指标纳入术前评估,辅助临床风险分层.
Objective:To explore the predictive value of preoperative systemic inflam-matory markers for pregnancy outcomes after cervical cerclage.Methods:A total of 124 single-ton pregnant women who underwent cervical cerclage and delivered in our hospital from January 1,2022 to October 30,2025 were selected and divided into three groups according to the indica-tions for cerclage:35 cases in the history-indicated group,66 cases in the ultrasound-indicated group,and 23 cases in the physical examination-indicated group.Inflammatory markers(SⅡ,SIRI,NMR,PLR,NLR,MLR)were calculated based on the peripheral blood of pregnant women.The distribution of these markers among the three groups with different cerclage indica-tions was compared.The relationship between inflammatory markers and pregnancy outcomes was evaluated by correlation analysis,and for the inflammatory markers with significant correla-tion,ROC curve analysis was further used to assess their predictive value.Results:Among the three groups with different cerclage indications,there were significant differences in SⅡ,SIRI,PLR,NLR and MLR(P<0.05).The above indicators in the physical examination-indicated group were significantly higher than those in the other two groups.The cerclage failure rate and the delivery rate before 34 weeks of gestation in this group were significantly higher than those in the other two groups(P<0.05),while the neonatal birth weight and 1-minute Apgar score were significantly lower,the NICU admission rate was significantly higher,and the interval from cerclage to delivery was the shortest.Correlation analysis showed that SⅡ,SIRI and NLR were significantly negatively correlated with gestational age at delivery,neonatal birth weight,1-mi-nute Apgar score and interval from cerclage to delivery(P<0.05).ROC curve analysis indica-ted that SⅡ,SIRI and NLR had statistically significant predictive value for delivery before 34 weeks of gestation and neonatal low birth weight(P<0.05).Conclusion:The levels of SⅡ,SI-RI and NLR are important biochemical markers for predicting the outcome of cervical cerclage and pregnancy outcomes.They can be used as non-invasive predictive indicators in preoperative assessment to assist clinical risk stratification.
刘影诺;王永萍;朱丽业;蒋红清
北京市海淀区妇幼保健院产科,北京 100084北京市海淀区妇幼保健院产科,北京 100084北京市海淀区妇幼保健院产科,北京 100084北京市海淀区妇幼保健院产科,北京 100084
医药卫生
全身炎症指标宫颈环扎术妊娠结局
Systemic inflammatory markersCervical cerclagePregnancy outcomes
《现代妇产科进展》 2026 (5)
357-362,6
北京市海淀区属卫生健康系统高层次人才计划发展项目(北京市卫生局重点学科基金)(No:2022HDXD006)
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