血尿素氮、D-二聚体联合胆固醇测定对重度子痫前期的辅助诊断价值  

Value of blood urea nitrogen, D-dimer combined with cholesterol test in the assistant diagnosis of severe preeclampsia

作　　者：刘倩[1] 梁婵玉 朱燕莉[2] 黄晓燕[2] 孙波[1,3] 赵卫华[1] LIU Qian;LIANG Chan-yu;ZHU Yan-li;HUANG Xiao-yan;SUN Bo;ZHAO Wei-hua(Department of Obstetrics,Shenzhen Second People’s Hospital,Shenzhen 518035,Guangdong,CHINA;Department of Obstetrics,Hechi People's Hospital,Hechi 547000,Guangxi,CHINA;Department of Obstetrics,Shenzhen Bao'an District Maternal and Child Health Hospital Affiliated to Jinan University,Shenzhen 518035,Guangdong,CHINA)

机构地区：[1]深圳市第二人民医院产科,广东深圳518035 [2]河池市人民医院产科,广西河池547000 [3]暨南大学附属深圳市宝安区妇幼保健院产科,广东深圳518035

出　　处：《海南医学》2022年第2期175-179,共5页Hainan Medical Journal

摘　　要：目的筛选血常规、肝肾功能、凝血功能及血脂检测中可用于辅助诊断子痫前期严重程度的指标并探讨其价值。方法选取2016年1月至2020年9月在广西壮族自治区河池市人民医院住院分娩的393例孕妇为研究对象,其中子痫前期组185例、重度子痫前期组208例,回顾性分析两组孕妇的一般临床资料及实验室检测指标,比较两组孕妇的差异性。采用Logistic回归筛选出重度子痫前期的独立影响指标,并用诊断试验与受试者工作特征曲线(ROC)分析血尿素氮(BUN)、D-二聚体(D-D)、胆固醇(CHOL)对子痫前期严重程度的辅助诊断价值。结果两组孕妇外周血血红蛋白、碱性磷酸酶、纤维蛋白原、活化部分凝血活酶时间比较差异均无统计学意义(P>0.05);重度子痫前期组孕妇的血小板计数、总蛋白、白蛋白、估算的肾小球滤过率、血钙水平分别为198.68(149.75,248.00)×10^(9)/L、(54.68±7.64)g/L、(30.49±5.15)g/L、(105.93±29.16)mL/(min·1.73 m^(2))、(2.05±0.27)mmol/L,明显低于子痫前期组的220.68(175.00,260.00)×10^(9)/L、(59.44±6.08)g/L、(33.88±4.01)g/L、(121.94±29.50)mL/(min·1.73 m^(2))、(2.16±0.23)mmol/L,而白细胞、谷草转氨酶、谷丙转氨酶、BUN、血肌酐、尿酸、乳酸脱氢酶、D-D、甘油三酯、CHOL水平分别为11.54(8.76,13.79)×10^(9)/L、62.78(19.00,41.00)U/L、41.26(12.00,32.25)U/L、5.05(3.54,5.92)mmol/L、71.58(52.75,81.25)μmol/L、(439.46±107.56)μmol/L、357.13(210.00,358.00)U/L、3.32(1.25,3.64)μg/mL、4.40(2.75,5.04)mmol/L、(6.90±2.07)mmol/L,明显高于子痫前期组的10.35(8.15,11.92)×10^(9)/L、29.33(16.00,27.00)U/L、23.77(10.00,21.00)U/L、3.69(2.84,4.28)mmol/L、55.63(44.00,66.50)μmol/L、(372.83±111.66)μmol/L、235.20(173.50,253.00)U/L、2.51(1.04,2.61)μg/mL、3.93(2.40,4.53)mmol/L、(5.72±1.47)mmol/L,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,BUN、D-D、CHOL是重度子痫前期的独立影响因素(OR=2.111、0.841�Objective To identify laboratory markers among blood routine,liver/kidney function,coagulation function,and blood lipid parameters variables that can be used for the diagnosis of severe preeclampsia.Methods We studied records of 393 women with preeclampsia in Department of Obstetrics,Hechi People’s Hospital located in Guangxi Zhuang Autonomous Region from January 2016 to September 2020,including 185 cases in the mild preeclampsia group and 208 cases in the severe preeclampsia group.The baseline characteristics and the laboratory parameters of blood of two groups were compared.Logistic regression method was used to analyze the independent influence index of severe preeclampsia.The diagnostic test and ROC analysis were used to analyze the assistant diagnostic value of urea nitrogen(BUN),D-Dimer(D-D),cholesterol(CHOL)for severe preeclampsia.Results There were no significant differences in blood hemoglobin(HGB),alkaline phosphatase(ALP),fibrinogen(FIB),activated partial thromboplastin time(APTT)between the two groups(P>0.05).In the severe preeclampsia group,the platelet count(PLT),total protein(TP),albumin(ALB),estimated glomerular filtration rate(eGFR),calcium(Ca)levels were 198.68(149.75,248.00)×10^(9)/L,(54.68±7.64)g/L,(30.49±5.15)g/L,(105.93±29.16)mL/(min·1.73 m^(2)),(2.05±0.27)mmol/L,respectively,significantly lower than 220.68(175.00,260.00)×10^(9)/L,(59.44±6.08)g/L,(33.88±4.01)g/L,(121.94±29.50)mL/(min·1.73 m^(2)),(2.16±0.23)mmol/L in the mild preeclampsia group,while the white blood cell(WBC),aspartate aminotransferase(AST),alanine aminotransferase(ALT),BUN,serum creatinine(CREA),uric acid(UA),lactate dehydrogenase(LDH),D-D,triglyceride(TG),CHOL levels were 11.54(8.76,13.79)×10^(9)/L,62.78(19.00,41.00)U/L,41.26(12.00,32.25)U/L,5.05(3.54,5.92)mmol/L,71.58(52.75,81.25)μmol/L,(439.46±107.56)μmol/L,357.13(210.00,358.00)U/L,3.32(1.25,3.64)μg/mL,4.40(2.75,5.04)mmol/L,(6.90±2.07)mmol/L,respectively,significantly higher than 10.35(8.15,11.92)×10^(9)/L,29.33(16.00,27.00)U/L,23.77(10.00,21.00)U/L,3

关 键 词：子痫前期 血尿素氮 D-二聚体 胆固醇 受试者工作特征曲线 

分 类 号：R714.245[医药卫生—妇产科学]