子痫前期发病的相关危险因素及其临床预测价值  

Risk Factors for Preeclampsia and Their Clinical Predictive Value

作　　者：郭会娟 刘宁 牛三强 陈东颖[1] GUO Huijuan;LIU Ning;NIU Sanqiang;CHEN Dongying(Department of Obstetrics and Gynecology,Bozhou People′s Hospital,Bozhou 236800,China)

机构地区：[1]亳州市人民医院妇产科,安徽亳州236800

出　　处：《医学综述》2022年第23期4765-4770,共6页Medical Recapitulate

基　　金：安徽理工大学校级资助项目(QN2019140)。

摘　　要：目的分析子痫前期发病的相关危险因素及其临床预测价值。方法采用便利抽样法选择2019年9月至2021年11月亳州市人民医院妇产科收治的65例子痫前期孕妇作为子痫前期组,选择同期就诊的65名健康孕妇作为健康对照组,收集所有研究对象年龄、既往妊娠史、既往分娩史、妊娠前收缩压及舒张压、妊娠前及子痫前期发病时体质量指数(BMI)以及孕16~20周的淋巴细胞计数、中性粒细胞计数等血液指标,采用Logistic回归分析子痫前期发病的相关危险因素,受试者工作特征曲线(ROC曲线)分析相关危险因素对子痫前期发病的预测价值。结果子痫前期组年龄大于健康对照组(P<0.01),两组妊娠前体质量、孕期增重分布比较差异有统计学意义(P<0.05),子痫前期组淋巴细胞计数、血小板计数、平均红细胞体积(MCV)、平均血小板体积、血小板分布宽度低于健康对照组(P<0.05或P<0.01),中性粒细胞计数、血小板-淋巴细胞比值、中性粒细胞-淋巴细胞比值(NLR)、血红蛋白(Hb)、血细胞比容(HCT)、红细胞分布宽度高于健康对照组(P<0.05或P<0.01)。Logistic回归分析结果显示,年龄、妊娠前体质量、NLR、HCT、MCV、Hb是子痫前期发病的独立危险因素(OR=1.376,95%CI 1.056~1.792;OR=1.576,95%CI 1.042~2.383;OR=1.799,95%CI 1.144~2.829;OR=1.844,95%CI 1.119~3.040;OR=2.044,95%CI 1.064~3.926;OR=1.948,95%CI 1.106~3.433)(P<0.05)。ROC曲线分析结果显示,年龄、妊娠前体质量、NLR、HCT、MCV、Hb预测子痫前期发病的灵敏度分别为77.4%、78.6%、76.9%、71.1%、73.8%、74.5%,特异度分别为72.5%、74.3%、73.2%、67.6%、69.7%、68.9%;而联合检测预测子痫前期发病的灵敏度为91.2%,特异度为78.6%。结论孕妇年龄、妊娠前体质量、NLR、HCT、MCV、Hb与子痫前期发病密切相关,且上述指标联合检测对子痫前期发病的预测价值较高。Objective To analyze the risk factors and their clinical predictive value for preeclampsia.Methods Convenience sampling method was used to select 65 cases of preeclampsia pregnant women admitted to the Department of Obstetrics and Gynecology of Bozhou People′s Hospital from Sep.2019 to Nov.2021 as a preeclampsia group,and 65 healthy pregnant women admitted to the department during the same period as a healthy control group.The age,history of pregnancy,history of childbirth,systolic blood pressure and diastolic blood pressure before pregnancy,body mass index(BMI)before pregnancy and early preeclampsia and blood analysis indexes such as lymphocyte count,neutrophil count at 16-20 weeks pregnancy of all the subjects were collected,and Logistic regression analysis was used to analyze the related risk factors for preeclampsia onset,and receiver operating characteristic curve(ROC curve)was used to analyze the predictive value of related risk factors for preeclampsia.Results The preeclampsia group was older than the healthy control group(P<0.01),and there were statistically significant differences in pre-pregnancy weight and pregnancy weight gain distribution between the two groups(P<0.05).The lymphocyte count,platelet count,mean corpuscular volume(MCV),mean platelet volume and platelet distribution width in the preeclampsia group were lower than those in the healthy control group(P<0.05 or P<0.01).Neutrophil count,platelet-lymphocyte ratio,neutrophil-lymphocyte ratio(NLR),hemoglobin(Hb),hematocrit(HCT)and erythrocyte distribution width were higher than those in the healthy control group(P<0.05 or P<0.01).Logistic regression analysis showed that age,pre-pregnancy weight,NLR,HCT,MCV and Hb were independent risk factors for preeclampsia(OR=1.376,95%CI 1.056-1.792;OR=1.576,95%CI 1.042-2.383;OR=1.799,95%CI 1.144-2.829;OR=1.844,95%CI 1.119-3.040;OR=2.044,95%CI 1.064-3.926;OR=1.948,95%CI 1.106-3.433)(P<0.05).ROC curve analysis showed that the sensitivity of age,pre-pregnancy weight,NLR,HCT,MCV and Hb to predict the incidence

关 键 词：子痫前期 血液分析 危险因素 预测价值 

分 类 号：R714.25[医药卫生—妇产科学]