血清红细胞葡糖6-磷酸脱氢酶联合超声检查对肝内胆汁淤积孕妇不良妊娠结局预测价值的研究  

The predictive value of serum glucose-6-phosphate dehydrogenase combined with ultrasound for the adverse outcome of pregnant women with intrahepatic cholestasis pregnancy

作　　者：许丽丽 XU Lili(Department of Obstetrics,Zhuzhou Central Hospital,Zhuzhou 412007,Hunan,China)

机构地区：[1]株洲市中心医院产科,湖南株洲412007

出　　处：《中国性科学》2021年第10期95-98,共4页Chinese Journal of Human Sexuality

摘　　要：目的探究血清红细胞葡糖6-磷酸脱氢酶(G6PD)联合超声检查对肝内胆汁淤积症(ICP)孕妇不良妊娠结局的预测价值。方法选取2017年4月至2019年10月株洲市中心医院确诊的118例ICP孕妇作为研究对象。根据妊娠结局分妊娠结局良好组(n=96)和不良妊娠结局组(n=22)。超声检查脐带动脉血流动力学指标;全自动生化分析仪检测血清中G6PD活性;绘制受试者工作特性(ROC)曲线分析并比较超声S/D、血清G6PD、超声S/D联合血清G6PD对ICP孕妇不良妊娠结局的预测价值。结果118例ICP孕妇中22例(43例次)发生不良妊娠结局,发生率为18.64%,其中胎儿窘迫7例次、流产2例次、早产11例次、新生儿窒息12例次、低体重儿8例次、围产儿死亡3例次。与妊娠结局良好组比较,不良妊娠结局组超声S/D水平升高,血清中G6PD活性降低,差异具有统计学意义(P<0.05)。ROC曲线显示,超声S/D、血清G6PD预测ICP孕妇不良妊娠结局的ROC曲线下面积分别为0.717、0.816,截断值为5.29U/gHb、11.14U/gHb,灵敏度为81.82%、77.27%,特异度为55.21%、71.88%;超声S/D联合血清G6PD预测ICP孕妇不良妊娠结局的ROC曲线下面积为0.885,灵敏度为90.91%,特异度为76.04%。与超声S/D相比,血清G6PD、超声S/D联合血清G6PD的特异度更高,差异具有统计学意义(P<0.05)。结论血清G6PD联合超声检查ICP孕妇不良妊娠结局的效果优于单独超声检查,可弥补超声检查特异度低的劣势,在临床上具有一定参考价值。Objective To explore the predictive value of serum glucose-6-phosphate dehydrogenase(G6PD)combined with ultrasound for the adverse outcome of intrahepatic cholestasis pregnancy(ICP).Methods 118 pregnant women with ICP diagnosed in Zhuzhou Central Hospital from April 2017 to October 2019 were selected and divided into good pregnancy outcome group(n=96)and bad pregnancy outcome group(n=22)as the study subjects according to pregnancy outcome.Ultrasonic examination was used to detect blood flow dynam-ics of umbilical cord.The activity of G6PD in serum for automatic biochemical analyzer.Receiver operating charac-teristic(ROC)curve was drawn to analyze and compare the predictive value of ultrasonic S/D,serum G6PD,ultra-sonic S/D combined with serum G6PD for adverse pregnancy outcomes in ICP pregnant women.Results Adverse pregnancy outcome occurred in 22 cases(43 numbers)of 118 pregnant women with ICP(18.64%),including 7 cases of fetal distress,2 cases of abortion,11 cases of premature delivery,12 cases of neonatal asphyxia,8 cases of low birth weight,and 3 cases of perinatal death.Compared with the group with good pregnancy outcome,the ultra-sonic S/D level was increased and serum G6PD activity was decreased in the group with poor pregnancy outcome(P<0.05).The ROC curve showed that the area under the ROC curve of ultrasonic S/D and serum G6PD for pre-dicting adverse pregnancy outcome of ICP pregnant women were 0.717 and 0.816,the cut-off value was 5.29U/gHb and 11.14U/gHb,the sensitivity was 81.82%and 77.27%,and the specificity was 55.21%and 71.88%,re-spectively.The area under ROC curve of ultrasonic S/D combined with serum G6PD for predicting adverse pregnan-cy outcome of ICP pregnant women was 0.885,the sensitivity was 90.91%,and the specificity was 76.04%.Com-pared with ultrasonic S/D,the specificity of serum G6PD and ultrasonic S/D combined with serum G6PD was high-er,and the difference was statistically significant(P<0.05).Conclusions Serum G6PD combined with ultra-sound is better than single ultrasound in detecti

关 键 词：血清红细胞葡糖6-磷酸脱氢酶 超声 肝内胆汁淤积症 不良妊娠结局 预测价值 

分 类 号：R714[医药卫生—妇产科学]