摘要
目的研究妊娠晚期多囊卵巢综合征(PCOS)患者发生妊娠期高血压(HDCP)的独立危险因素,并建立风险模型,为临床上妊娠晚期多囊卵巢综合征患者及早预防妊娠期高血压的发生提供指导。方法随机选取2015年1月至2019年3月西宁市第三人民医院诊治的288例妊娠晚期PCOS合并HDCP患者和346例同期HDCP患者作为研究对象。收集患者临床基线资料,比较临床资料差异、分析危险因素以及ROC,并建立预测模型。结果Logistic回归分析中,不良妊娠史对于HDCP的发生影响度较低,对HDCP发生影响度最高的为有HDCP家族史:β值=2.339,OR值=10.37,95%CI:5.813~18.499;其次为有高血压家族史:β值=1.65,OR值=5.21,95%CI:2.942~9.255;对HDCP发生影响度较低的为年龄和BMI,β值分别为0.43、0.5,OR值分别为=0.65、0.606,95%CI分别为0.581~0.728、0.546~0.674;避孕药使用史及长期被动吸烟史均有较高的影响度。再次通过多因素Logistic回归分析可知,结果与单因素回归相似。两者结果结合分析表明,年龄、BMI、有高血压家族史、有避孕药使用史、有长期吸烟史、有HDCP家族史是影响PCOS妊娠期高血压发生的独立危险因素。ROC受试者工作曲线分析显示,敏感度最高的为年龄(94.44%),特异度最高的为BMI(96.24%)。除有避孕药使用史外的5因素联合预测PCOS妊娠期高血压的曲线下面积(AUC)为0.939(P<0.001),约登指数为0.7229,敏感度为84.72%,特异度为87.57%,对于POCS的预测有着良好的敏感度与特异度,预测价值良好。结论年龄、BMI、有原发性高血压及妊娠期高血压家族史是影响多囊卵巢综合征患者发生妊娠期高血压的独立危险因素。年龄、BMI、有高血压家族史、有长期吸烟史和有HDCP家族史等5因素联合对预测妊娠期高血压的发生有较高的价值。
Objective To study the independent risk factors of hypertensive disorder complicating pregnancy(HDCP)in patients with polycystic ovary syndrome(PCOS)in the third trimester of pregnancy,and to establish a risk model to provide guidance for the early prevention of hypertensive gestation in patients with PCOS in the third trimester.Methods 288 patients with PCOS and HDCP in the third trimester of pregnancy and 346 patients with non-pregnant hypertension in Xi′ning Third People′s Hospital from January 2015 to March 2019 were selected.Clinical data was collected.Risk factors analysis and ROC analysis was performed and predictive models were established.Results According to the logistic regression analysis,the adverse pregnancy history had little impact on the occurrence of HDCP,and family history of HDCP had the largest impact(β=2.339,OR=10.37,95%CI:5.813~18.499),followed by family history of hypertension(β=1.65,OR=5.21,95%CI:2.942~9.255),and age and BMI had small impact on the occurrence of HDCP(β=0.43,0.5,OR=0.65/0.606,95%CI:0.581~0.728,0.546~0.674),and the history of contraceptive pills use and long-term passive smoking history had large impact.According to multivariate logistic regression analysis whose results were similar to binary regression that,age,BMI,family history of hypertension,history of contraceptive pills use,long-term smoking history,and family history of HDCP were independent risk factors.Receiver operating characteristics curve(ROC)analysis showed that age was of the highest sensitivity(94.44%)and BMI was of the highest specificity(96.24%).The area under the curve(AUC)of joint predictions was 0.939,P<0.001.The Yodel value was 0.7229,the sensitivity was 84.72%,and the specificity was 87.57%,which was of good prediction sensitivity and specificity for the prediction of POCS.Conclusions Age,BMI,and family history of primary hypertension and HDCP are independent risk factors that affect HDCP in patients with PCOS,and the joint detection is of high value in predicting the occurrence of HDCP.
作者
唐晓慧
李海艳
TANG Xiaohui;LI Haiyan(Department of Obstetrics,Xining Third People′s Hospital,Xi′ning 810005,Qinghai,China;Department of Obstetrics and Gynecology,Qinghai Red Cross Hospital,Xi′ning 810000,Qinghai,China)
出处
《中国性科学》
2020年第5期56-60,共5页
Chinese Journal of Human Sexuality
关键词
多囊卵巢综合征
妊娠期高血压
危险因素
风险预测模型
Polycystic ovary syndrome(PCOS)
Hypertensive disorder complicating pregnancy(HDCP)
Risk factors
Risk prediction model
