血清游离雌三醇与AFP水平联合血栓弹力图指标在子痫前期预测中的应用价值  

Predictive value of serum unconjugated estriol and AFP combined with thromboelastogram indexes for preeclampsia

作　　者：吴博 苗艺璇 臧娅 吴风华 WU Bo;MIAO Yi-xuan;ZANG Ya;WU Feng-hua(Department of Obstetrics,Luohe Maternal and Child Health Hospital,Luohe,Henan 462300,China;Department of Obstetrics and Gynecology,Luohe Maternal and Child Health Care Hospital,Luohe,Henan 462300,China;Clinical Laboratory,Luohe Maternal and Child Health Care Hospital,Clinical Laboratory,Luohe,Henan 462300,China)

机构地区：[1]漯河市妇幼保健院产科,河南渭河462300 [2]漯河市妇幼保健院妇产科,河南渭河462300 [3]漯河市妇幼保健院检验科,河南渭河462300

出　　处：《医药论坛杂志》2023年第11期96-99,103,共5页Journal of Medical Forum

摘　　要：目的探讨血清游离雌三醇(uE3)、甲胎蛋白(AFP)联合血栓弹力图(TEG)在子痫前期预测中的应用价值探究。方法选取2019年1月—2020年1月在漯河市妇幼保健院确诊为子痫前期的孕妇62例作为研究对象,其中34例孕妇为轻度子痫前期,28例孕妇为重度子痫前期,另选取同期在本院产检正常孕妇55例作为对照组。检测所有孕妇的血清uE3、AFP及TEG指标[凝血反应时间(R)、凝固速率(K)、最大振幅(MA)、凝固角(α)]水平;采用受试者工作特征曲线(ROC)评价uE3、AFP及TEG指标对子痫前期的诊断价值;Pearson相关性分析uE3、AFP及TEG指标与子痫前期严重程度的相关性。结果子痫前期组孕妇血清AFP、uE3、MA值均低于对照组,子痫前期组孕妇血清R值、K值均高于对照组(P<0.05);轻度子痫前期孕妇血清AFP、uE3、MA值均高于重度子痫前期孕妇,轻度子痫前期孕妇血清R值、K值均低于重度子痫前期孕妇(P<0.05);R值、AFP、uE3、MA值、K值及其联合检测预测子痫前期的AUC分别为0.701、0.706、0.721、0.729、0.747、0.903(P<0.05);R值、K值与子痫前期严重程度呈正相关性,AFP、uE3、MA值与子痫前期严重程度呈负相关性(P<0.05)。结论血清uE3、AFP及TEG指标变化能预测子痫前期的发生,且其联合检测能提高诊断效能。Objective To explore the predictive value of serum unconjugated estriol(uE3)and alpha-fetoprotein(AFP)combined with thromboelastogram(TEG)indexes for preeclampsia.Methods A total of 62 pregnant women confirmed with preeclampsia by antenatal examination in the Luohe City Maternal and Child Health Hospital were en-rolled as the research objects between January 2019 and January 2020,including 34 cases with mild preeclampsia and 28 cases with severe preeclampsia.And 55 normal pregnant women during the same period were enrolled as control group.The levels of serum uE3,AFP and TEG indexescoagulation reaction time(R),K-time(K),maximum amplitude(MA),α-angle(α)J were detected.And their diagnostic value for preeclampsia was evaluated by receiver operating characteristic(ROC)curves.The correlation between uE3,AFP,TEG indexes and the severity of preeclampsia was an-alyzed by Pearson corelation analysis.ResultsThe serum AFP,uE3 and MA in preeclampsia group were lower than those the control group,serum R and K in preeclampsia group were higher(P<0.05).Serum AFP,uE3 and MA in pregnant women wuth mild preeclampsia group were higher than those with severe preeclampsia,while serum R and K were lower than those with severe preeclampsia(P<0.05).AUC values of R,AFP,uE3,MA,K and combined detec-tion for predicting preeclampsia were 0.701,0.706,0.721,0.729,0.747 and 0.903,respectively(P<0.05).R and K were positively correlated with the severity of preeclampsia,while AFP,uE3 and MA were negatively correlated with it(P<0.05).Conclusion Changes of serum uE3,AFP and TEG indexes can predict the occurrence of preeclampsia.And their combined detection can improve the diagnostic efficiency.

关 键 词：游离雌三醇 甲胎蛋白 血栓弹力图 子痫前期 预测 

分 类 号：R446[医药卫生—诊断学]