子痫前期患者不良妊娠结局的影响因素分析及孕中期血清微量元素的预测价值  

The influencing factors of adverse pregnancy outcomes in patients with preeclampsia and the predictive value of serum trace elements in the second trimester

作　　者：余俊峰 李洪英 万国菊 吴立涛 杨秋香 高洁 卢蓉 YU Junfeng;LI Hongying;WAN Guoju;WU Litao;YANG Qiuxiang;GAO Jie;LU Rong(Department of Obstetrics,Qujing First People′s Hospital,Qujing,Yunnan 655000,China;Department of Obstetrics,Beicheng Hospital,Qujing First People′s Hospital,Qujing,Yunnan 655000,China)

机构地区：[1]曲靖市第一人民医院产科,云南曲靖655000 [2]曲靖市第一人民医院北城医院产科,云南曲靖655000

出　　处：《国际检验医学杂志》2024年第6期667-670,675,共5页International Journal of Laboratory Medicine

基　　金：中华国际科学交流基金会检验检测科技专项基金项目(Z2019LYN001)。

摘　　要：目的探讨子痫前期患者不良妊娠结局的影响因素及孕中期血清微量元素的预测价值。方法将2019年1月至2022年6月曲靖市第一人民医院收治的98例子痫前期患者纳入研究。根据患者是否出现不良妊娠结局分为结局不良组和结局良好组。收集所有纳入研究患者的临床资料并在孕中期进行血清微量元素钙、铜、锌、铁水平的检测。采用单因素分析和多因素Logistic回归分析子痫前期患者不良妊娠结局的影响因素。比较结局不良组和结局良好组孕中期血清微量元素水平。采用受试者工作特征(ROC)曲线评估血清微量元素钙、铜、锌、铁对子痫前期患者不良妊娠结局的预测价值。结果单因素分析显示,结局不良组收缩压、24 h尿蛋白、D-二聚体水平均高于结局良好组(P<0.05),入院孕周、血小板计数均少于结局良好组(P<0.05)。多因素Logistic回归分析显示,24 h尿蛋白、D-二聚体、血小板计数均是痫前期患者不良妊娠结局的影响因素(P<0.05)。结局不良组孕中期血清微量元素钙、铜、锌水平均明显低于结局良好组(P<0.05),铁水平明显高于结局良好组(P<0.05)。ROC曲线分析显示,孕中期血清钙、铜、锌、铁预测子痫前期患者不良妊娠结局的曲线下面积(AUC)分别为0.830(95%CI:0.780~0.880)、0.855(95%CI:0.805~0.905)、0.847(95%CI:0.797~0.897)、0.861(95%CI:0.811~0.911)。结论子痫前期患者不良妊娠结局与患者24 h尿蛋白、D-二聚体、血小板计数有关。孕中期血清微量元素钙、铜、锌、铁水平在不良妊娠结局的患者中存在明显变化,可能成为患者不良妊娠结局的预标志物。Objective To investigate the influencing factors of adverse pregnancy outcomes in patients with preeclampsia and the predictive value of serum trace elements in the second trimester.Methods A total of 98 patients with preeclampsia admitted to Qujing First People′s Hospital from January 2019 to June 2022 were enrolled in the study.Patients were divided into poor outcome group and good outcome group according to whether they had adverse pregnancy outcomes.The clinical data of all patients enrolled in the study were collected and the serum levels of trace elements calcium,copper,zinc and iron were detected in the second trimester.Univariate analysis and multivariate Logistic regression were used to analyze the influencing factors of adverse pregnancy outcomes in patients with preeclampsia.The levels of serum trace elements in the second trimester of pregnancy were compared between the poor outcome group and the good outcome group.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum trace elements calcium,copper,zinc and iron for adverse pregnancy outcomes in patients with preeclampsia.Results Univariate analysis showed that compared with the good outcome group,the poor outcome group had significantly higher systolic blood pressure,24 h urinary protein quantitation,and D-dimer level(P<0.05)and significantly less gestational age and platelet count at admission(P<0.05).Multivariate Logistic regression analysis showed that 24 h urinary protein quantification,D-dimer and platelet count were the influencing factors of adverse pregnancy outcomes in patients with preeclampsia(P<0.05).The levels of serum trace elements calcium,copper,and zinc in the poor outcome group were significantly lower than those in the good outcome group(P<0.05),and the level of iron was significantly higher than that in the good outcome group(P<0.05).ROC curve analysis showed that the areas under the curves(AUCs)of serum calcium,copper,zinc,and iron in the second trimester of pregnancy for predicting a

关 键 词：子痫前期 不良妊娠结局 微量元素 预测价值 

分 类 号：R446.11[医药卫生—诊断学] R714.245[医药卫生—临床医学]