妊娠早、中期维生素A、E水平及其变化预测子痫前期的价值分析  

Analysis on the value of vitamin A and E levels and their changes in the first and second trimesters of pregnancy in the prediction of preeclampsia

作　　者：罗国英[1] 李婵[1] 邹美玲 李仲均[1] LUO Guoying;LI Chan;ZOU Meiling;LI Zhongjun(Department of Gynecology and Obstetrics,Dongguan People's Hospital in Guangdong Province,Dongguan523000,China)

机构地区：[1]广东省东莞市人民医院妇产科,广东东莞523000

出　　处：《中国现代医生》2020年第20期32-35,共4页China Modern Doctor

基　　金：国家卫生计生委医药卫生科技发展研究中心科研项目(W2016CWGD05);广东省医学科学技术研究基金项目(C2017034);广东省东莞市科技计划医疗卫生类科研一般项目(2018507150011269)。

摘　　要：目的研究妊娠早期及中期维生素A、E水平及其浓度变化在预测子痫前期发病中的价值。方法回顾性调取2017年1月~2018年6月在我院分娩孕妇的妊娠早期及中期的维生素A和维生素E数据,其中正常孕妇759例(正常组),子痫前期孕妇63例(PE组),通过受试者工作特征(ROC)曲线及二元逻辑回归,比较两组孕妇妊娠早期和中期VA和VE浓度及其差值预测子痫前期发病的价值。结果PE组孕妇维生素A降低的幅度大于正常组(P<0.05),而两组孕妇妊娠早期与中期VA、VE水平及VE的变化幅度均无统计学差异(均P>0.05);PE与妊娠中-早期VA差值呈负相关(r=-0.118,P<0.05),而与年龄、妊娠早期和中期VA、VE水平及妊娠中-早期VE差值无相关性(均P>0.05);妊娠中-早期VA差值预测PE发生的ROC曲线下面积(AUC)为0.628[95%CI(0.554,0.701),P=0.000],截断值为-0.11 mg/L,此时灵敏度为41.3%,特异度为76.4%,而其它参数预测PE发生的P值均>0.05;妊娠中期与早期VA差值≤-0.11 mg/L和VE差值≤1.15 mg/L是PE发病的独立影响因素(均P<0.05)。结论妊娠早期至中期维生素A及维生素E的变化幅度,较之单次检测的浓度,能更有效地预测子痫前期的发病,提示妊娠期应该动态监测维生素A及维生素E的浓度变化,合理补充,有望降低PE的发病率。Objective To study the value of vitamin A and E levels and their concentration changes in the first and second trimesters of pregnancy in the prediction of the onset of preeclampsia.Methods The data of vitamin A and vitamin E in the pregnant women in the first and second trimesters who gave birth in our hospital from January 2017 to June 2018 were retrospectively collected.Among them,there were 759 cases of normal pregnant women(normal group)and 63 cases of preeclampsia pregnant women(PE group).Through receiver operating characteristic(ROC)curve and binary logistic regression,the values of VA and VE concentrations in the first and second trimesters of pregnancy and their differences to predict the onset of preeclampsia were compared between the two groups of pregnant women.Results The decrease of vitamin A in pregnant women in PE group was greater than that in normal group(P<0.05).However,there was no statistically significant difference in the levels of VA and VE and changes of VE in the first and second trimesters of pregnancy between the two groups of pregnant women(both P>0.05).PE was negatively correlated with the difference of VA between the first and second trimesters of pregnancy(r=-0.118,P<0.05),but was not correlated with age,VA and VE levels in the first and second trimesters of pregnancy,and the difference of VE between the first and second trimesters(all P>0.05).The area under the ROC curve(AUC)predicted by the VA difference between the first and second trimesters of pregnancy was 0.628[95%CI(0.554,0.701),P=0.000],and the cutoff value was-0.11 mg/L.At this time,the sensitivity was 41.3%,and the specificity was 76.4%.The P values of other parameters predicting the onset of PE were all>0.05.The difference of VA of≤-0.11 mg/L and the difference of VE of VE≤1.15 mg/L between the first and second trimesters of pregnancy were independent influencing factors for the incidence of PE(both P<0.05).Conclusion The changes of vitamin A and vitamin E from the first trimester to the second trimester of pregnanc

关 键 词：子痫前期 维生素A 维生素E 浓度变化 预测 

分 类 号：R714.244[医药卫生—妇产科学]