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目的:评价5种免疫与感染相关抗体联合检测在稽留流产患者中的诊断价值。方法:采用ELISA法检测177例稽留流产患者和156例正常妊娠妇女血清中的5种抗体水平(抗心磷脂抗体、抗精子抗体、抗子宫内膜抗体、Torch IgM抗体和Torch IgG抗体),对单一和联合检测结果进行流行病学分析后进行评价并确定最佳抗体组合。结果:每种抗体水平在稽留流产患者血清中的阳性率均显著高于对照组(P<0.05),单一抗体检测的灵敏度较低,在10.2%～48.0%之间,约登指数也较低,在0.089～0.416之间;抗体联合检测的诊断价值高于单一抗体检测,其中5种抗体组合联合检测为最佳组合,灵敏度为89.3%,特异度为85.3%,约登指数为0.746,一致率为87.4%,阳性似然比为6.07,阴性似然比为0.125,阳性预测值为87.3%,阴性预测值为87.5%。结论:联合检测5种免疫与感染相关抗体对稽留流产具有较高的诊断价值,可提高稽留流产的检出率,有助于早期诊断。
OBJECTIVE: To evaluate the diagnostic value of the combined detection of five immune-related antibodies in missed abortion patients. Methods: Serum levels of five antibodies (anticardiolipin, antisperm, endometrial, Torch IgM, and Torch IgG) were measured by ELISA in 177 missed abortion patients and 156 normal pregnant women. Single and combined test results were analyzed by epidemiology and the best combination of antibodies was determined. Results: The positive rate of each antibody was significantly higher in patients with missed abortion than those in control group (P <0.05). The sensitivity of single antibody test was low, and the Youden index was also lower between 10.2% and 48.0% , Between 0.089 and 0.416. The diagnostic value of the combined antibody test was higher than that of the single antibody test. Among them, the combination of the five antibody tests was the best combination with a sensitivity of 89.3%, a specificity of 85.3% and a Youden index of 0.746 The odds ratio was 87.4%, the positive likelihood ratio was 6.07, the negative likelihood ratio was 0.125, the positive predictive value was 87.3% and the negative predictive value was 87.5%. Conclusion: The combined detection of five immune-related and antibody-related antibodies has high diagnostic value for missed abortion, which can improve the detection rate of missed abortion and contribute to early diagnosis.