叶酸、体质指数及凝血指标与子痫前期的相关性分析  

Correlation analysis between folic acid, body mass index, blood coagulation indexes and preeclampsia

作　　者：何丽[1] 赖雪梅[1] 朱晓芳[1] 黄金园 王薇[1] HE Li;LAI Xuemei;ZHU Xiaofang;HUANG Jinyuan;WANG Wei(Chongqing maternal and Child Health Hospital,Chongqing,401147,China)

机构地区：[1]重庆市妇幼保健院妇女保健科,401147

出　　处：《中国妇产科临床杂志》2021年第5期495-497,共3页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：2017重庆市卫生计生委医学科研项目(2017MSXM108)。

摘　　要：目的分析叶酸、体质指数(BMI)及凝血指标与子痫前期的相关性。方法选取子痫前期孕妇(86例)和正常孕妇(55例),分析孕前BMI、妊娠早期(孕周11~12周)叶酸、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)与子痫前期及妊娠结局的关系。结果与对照组比较,子痫前期孕妇血清叶酸、凝血指标PT、APTT水平降低,而孕前BMI和FIB升高(P <0.05);受试者工作特征(ROC)曲线分析显示,叶酸、孕前BMI及凝血指标联合检测预测子痫前期,曲线下面积(AUC)为0.853(95%置信区间为0.778~0.905);与良好妊娠结局组相比,不良妊娠结局组血清叶酸水平降低,FIB升高(P <0.05),而两组孕前BMI、PT、APTT水平比较,差异均无统计学意义(P>0.05)。结论孕前BMI、妊娠早期叶酸、凝血指标(PT、APTT、FIB)联合检测对子痫前期有较高的预测价值,并可评估患者妊娠结局。Objective To analyze the correlation between folic acid, body mass index(BMI), blood coagulation indexes and preeclampsia. Methods A total of 86 pregnant women confirmed with preeclampsia from January 2018 to December 2020 were enrolled. According to different severity, they were divided into severe preeclampsia(severe group) and mild preeclampsia(mild group). 55 normal pregnant women during the same period were enrolled as the control group. Predictive effects of pregestational BMI, folic acid in first trimester(11~12 weeks), prothrombin time(PT), activated partial thromboplastin time(APTT) and fibrinogen(FIB) for preeclampsia were analyzed. Results Compared with control group, levels of serum folic acid and coagulation indexes(PT, APTT) in preeclampsia pregnant women decreased, while BMI and FIB increased(P < 0.05).The analysis of receiver operating characteristic(ROC) curves showed that area under the curve(AUC) and 95% confidence interval of folic acid combined with BMI and coagulation indexes for predicting preeclampsia were 0.853 and(0.778 ~ 0.905) respectively. Compared with mild group, levels of serum folic acid and APTT in the severe group were decreased, while FIB was increased(P < 0.05). Pearson correlation analysis showed that levels of serum folic acid and APTT were negatively correlated with severity of preeclampsia(r=-0.483,-0.451, P <0.05), while BMI and FIB were positively correlated with it(r =0.527, 0.420, P <0.05). Conclusion The combined detection of pregestational BMI, folic acid in early pregnancy and coagulation indexes(PT, APTT, FIB) is of high predictive value for preeclampsia and closely related to disease severity.

关 键 词：子痫前期 叶酸 体质指数 凝血指标 预测价值 

分 类 号：R714.244[医药卫生—妇产科学]