摘要
目的探讨孕期维生素A、维生素E水平和平均血小板体积等血清学指标预测子痫前期的价值。方法将2017年1月至2019年1月进行体检并建档的孕妇根据孕期是否发生子痫前期分为正常组和子痫前期组。比较两组孕妇维生素A、维生素E水平和平均血小板体积等血清学指标,采用多因素logistic回归分析影响孕妇发生子痫前期的因素,采用ROC曲线分析各因素预测孕妇发生子痫前期的诊断价值。结果共纳入1000例孕妇,其中38例在研究过程中失联,其余孕妇中46例诊断为子痫前期,发病率为4.78%(46/962)。子痫前期组有子痫前期家族史的比例高于正常组,差异有统计学意义(P<0.05)。子痫前期组平均血小板体积、甘油三酯(TG)和超敏C反应蛋白(hs-CRP)均高于正常组,维生素A、维生素E水平均低于正常组,差异均有统计学意义(均P<0.01)。多因素logistic回归分析显示,平均血小板体积、TG和hs-CRP是孕妇发生子痫前期的危险因素(OR=1.567、3.039和5.466,均P<0.01),维生素A和维生素E水平是孕妇发生子痫前期的保护因素(OR=0.000和0.764,均P<0.01)。ROC曲线分析显示,维生素A、维生素E、平均血小板体积、TG、hs-CRP预测孕妇发生子痫前期的最佳截点的曲线下面积(AUC)分别是0.778、0.713、0.728、0.674和0.714,其中维生素A的AUC高于其他指标(P<0.05),此时最佳截点为≤0.47,灵敏度为0.845、特异度为0.595。结论维生素A、维生素E水平、平均血小板体积、TG和hs-CRP可有效预测孕妇发生子痫前期的风险,值得临床推广。
Objective To investigate the relationship between serum test findings and risk of preeclampsia in pregnant women.Methods The clinical data of 1000 pregnant women,who underwent physical examination from January 2017 to January 2019,were retrospectively analyzed.The laboratory test results were compared between patients with preeclampsia and normal pregnant women.Multivariate Logistic regression was used to analyze the risk factors for preeclampsia;ROC curve was used to evaluate the predictive value of relevant indexes in predicting preeclampsia of pregnant women.Results Thirty eight cases were lost in follow-up,46 cases were diagnosed with preeclampsia with an incidence rate of 4.78%(46/962).There was no significant difference between the two groups in age,blood pressure,gravida and other indicators(all P>0.05).However,more pregnant women in preeclampsia group had family history of preeclampsia than those in normal group(P<0.05).There were no significant differences in GLU and TC levels between two groups(both P>0.05);however,TG,hs-CRP and mean platelet volume in preeclampsia group were all higher than those in normal group(all P<0.01),vitamin A and vitamin E levels in preeclampsia group were lower than those in normal group(both P<0.01).Multivariate logistic regression analysis showed that TG(OR=3.039),hs-CRP(OR=5.466)and mean platelet volume(OR=1.567)were independent risk factors for preeclampsia in pregnant women;vitamin A(OR=0.000)and vitamin E(OR=0.764)were protective factors for preeclampsia.The ROC curve showed that the area under the curve(AUC)of TG,hs-CRP,mean platelet volume,vitamin A and vitamin E for risk prediction of preeclampsia was 0.778,0.713,0.728,0.674 and 0.714,the AUC of vitamin A was higher than that of other indexes(P<0.05).Taking≤0.47mg/L as optimal cut-off point of vitamin A,the sensitivity was 0.845 and the specificity was 0.595 in predicting of preeclampsia.Conclusion Vitamin A and vitamin E levels and mean platelet volume are effective predictors for the risk of preeclampsia in pregna
作者
董琳娜
来丹
DONG Linna;LAI Dan(Department of Obstetrics and Gynecology,Fenghua District Maternal and Child Health Hospital,Ningbo 315500,China)
出处
《浙江医学》
CAS
2020年第5期430-433,共4页
Zhejiang Medical Journal
基金
国家卫生计生委医药卫生科技发展研究中心项目(W2016CWZJ01)。
