| ObjectiveBy detecting the expression levels of Caspase-8 and SAA in serum of patients with missed abortion and normal early pregnancy,and their expression localization and expression levels in villi and decidua tissues of patients with missed abortion and normal early pregnancy,the differences between the two expression levels were further analyzed,and the relationship between Caspase-8 and SAA and missed abortion was preliminarily discussed.MethodsFifty-four patients diagnosed as missed abortion in the obstetrics department of Yan ’an University Affiliated Hospital from July 2022 to December 2022 were collected as the experimental group.Thirty-three women who requested termination of normal early pregnancy in the obstetrics department of Yan ’an University Affiliated Hospital were randomly selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the OD values of Caspase-8 and SAA in serum of 30 women with normal early pregnancy and 30 women with missed abortion,and the concentrations of Caspase-8 and SAA in serum were calculated.The expressions of Caspase-8 and SAA in villi and decidua of 33 women with normal early pregnancy and 54 women with missed abortion were detected by immunohistochemical method of Streptomyces avidin-peroxidase(SP method),and the immunohistochemical staining results of pathological sections were semi-quantitatively calculated by comprehensive scoring method.All the data were input into SPSS20.0 software for statistical analysis.This study was approved by the Ethics Committee of the Affiliated Hospital of Yan ’an University.Results1.There was no significant difference in age and body mass index between the experimental group and the control group(P > 0.05),and it was not considered that the age and body mass index of pregnant women were related to missed abortion.Compared with the control group,the number of days and times of pregnancy in the experimental group was statistically significant(P < 0.05).It can be considered that the number of days and times of pregnancy in pregnant women are related to missed abortion.2.Caspase-8 and SAA can be detected in serum of patients with missed abortion and women with normal early pregnancy requires termination.Compared with the control group,the concentrations of Caspase-8 and SAA in the experimental group are higher than those in the control group,and the differences are statistically significant(P <0.05).It can be considered that Caspase-8 and SAA are related to missed abortion.3.Multivariate Logistic regression showed that the number of days of pregnancy(OR=1.01,95% CI: 0.948 ～ 1.076)and the number of pregnancies(OR=0.398,95% CI:0.039 ～ 4.026)were not independent risk factors for missed abortion(P > 0.05).Caspase-8(OR=124.310,95% CI: 7.934 ～ 1947.812)and SAA(OR=1.896,95% CI:1.095 ～ 3.285)were independent risk factors for missed abortion(P < 0.05).4.Predictive value of independent indexes in serum for missed abortion: When Jordan index is 0.667 and 0.500 respectively,the calculated critical values are 2.20ng/ml and 3.03μg/ml respectively.Caspase-8 can predict the risk efficiency of missed abortion.The area under the curve is 0.883(95% CI: 0.795 ～ 0.971),with sensitivity of 86.7% and specificity of 80.0%.The AUC values of the above prediction indexes were statistically significant(P < 0.05).SAA can predict the risk efficiency of missed abortion.The area under the curve is 0.791(95% CI: 0.677 ～ 0.905),the sensitivity is 76.7%,and the specificity is 73.3%.5.Expression level of Caspase-8 in villi and decidua: Compared with the control group,the positive expression of Caspase-8 in the experimental group(41 cases)was significantly higher than that in the control group(9 cases);The positive expression rate of Caspase-8 was 75.93% in the experimental group and 27.27% in the control group.The difference was statistically significant(P < 0.001)after four-grid data chi-square test.6.Expression level of SAA in villi and decidua: Compared with the control group,the positive expression of SAA in the experimental group(28 cases)was significantly higher than that in the control group(4 cases);The positive expression rate of SAA was51.85% in the experimental group and 12.12% in the control group.The difference was statistically significant(P < 0.001)after four-grid data chi-square test.Conclusion1.The high level of serum Caspase-8 and SAA in patients with missed abortion may be one of the important causes of missed abortion.2.Through Logistic regression analysis,it was found that Caspase-8 and SAA were independent influencing factors of missed abortion,and its mechanism may be that the high expression of Caspase-8 and SAA in villi and decidua tissue led to embryonic dysplasia and then embryonic death. |
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