子痫前期患者ACR、PLT、D-D水平变化及其在预测不良妊娠结局中的价值  

Changes of ACR,PLT and D-D in Patients with PE and Their Predictive Values for Adverse Pregnancy Outcomes

作　　者：刘芳 杨堃[2] 何泉江[1] 明雪 胡寒 LIU Fang;YANG Kun;HE Quanjiang;MING Xue;HU Han(Department of Obstetrics,Suining Central Hospital,Suining,629000,China;Department of Gynecology,Suining Central Hospital,Suining,629000,China)

机构地区：[1]遂宁市中心医院产科,四川遂宁629000 [2]遂宁市中心医院妇科,四川遂宁629000

出　　处：《标记免疫分析与临床》2024年第3期502-506,共5页Labeled Immunoassays and Clinical Medicine

基　　金：四川省医学会(恒瑞)科研基金专项科研课题(编号:2021HR54)。

摘　　要：目的探讨子痫前期(PE)患者尿蛋白/肌酐比值(ACR)、血小板计数(PLT)、D-二聚体(D-D)水平变化及其在预测不良妊娠结局中的价值。方法回顾性选取2019年10月至2022年10月在本院就诊的103例PE患者为PE组,另取同期40例正常妊娠产妇为对照组。测定两组受试者ACR、PLT、D-D水平,根据病情严重程度,将PE患者分为重度组和轻度组,比较不同病情严重程度患者ACR、PLT、D-D水平,根据妊娠结局,将PE患者分为妊娠结局良好组和妊娠结局不良组,比较不同妊娠结局患者ACR、PLT、D-D水平,并分析ACR、PLT、D-D评估不良妊娠结局的价值。结果PE组ACR和D-D水平高于对照组,PLT水平低于对照组(P<0.05);重度组ACR和D-D水平高于轻度组,PLT水平低于轻度组(P<0.05);妊娠结局不良组ACR和D-D水平高于妊娠结局良好组,PLT水平低于妊娠结局良好组(P<0.05);ROC曲线结果显示,ACR评估患者不良妊娠结局的AUC和截点值分别为0.799、89.61mg/mmol,PLT评估患者不良妊娠结局的AUC和截点值分别为0.860、52.05×10^(9)/L,D-D评估患者不良妊娠结局的AUC和截点值分别为0.762、1.52μg/mL,联合评估患者不良妊娠结局的AUC为0.930,高于单项评估(P<0.05)。结论PE患者中ACR和D-D水平上升,PLT水平下降,这3个指标均与患者病情严重程度有关,且联合评估不良妊娠结局价值较高。Objective To investigate changes of albuminuria to creatinine ratio(ACR),platelet count(PLT)and D-dimer(D-D)in patients with preeclampsia(PE)and their predictive values for adverse pregnancy outcomes.Methods A total of 103 patients with PE treated in the hospital were retrospectively enrolled as PE group between October,2019 and October,2022,while 40 normal pregnant women during the same period were enrolled as the control group.Levels of ACR,PLT and D-D in these two groups were detected.According to the disease severity,PE patients were divided into the severe group and mild group,and levels of ACR,PLT and D-D in these two groups were compared.According to different pregnancy outcomes,PE patients were divided into the good outcome group and poor outcome group,and levels of ACR,PLT and D-D in these two groups were compared.The evaluation value of ACR,PLT and D-D for adverse pregnancy outcomes was analyzed.Results Levels of ACR and D-D in PE group were higher than those in the control group,while PLT was lower(P<0.05).Levels of ACR and D-D in the severe group were higher than those in the mild group,while PLT was lower than that in the mild group(P<0.05).Levels of ACR and D-D in the poor outcome group were higher than those in the good outcome group,while PLT was lower(P<0.05).ROC curves analysis showed that AUC and cut-off values of ACR,PLT and D-D for evaluating adverse pregnancy outcomes were(0.799,89.61 mg/mmol),(0.860,52.05×10^(9)/L)and(0.762,1.52μg/mL),respectively.AUC of combined detection was 0.930,greater than that of single-index test(P<0.05).Conclusion Levels of ACR and D-D increase and PLT decreases in PE patients.These three indexes are related to disease severity,and the combined detection has a high evaluation value for adverse pregnancy outcomes.

关 键 词：子痫前期 尿蛋白/肌酐比值 血小板计数 D-二聚体 不良妊娠结局 

分 类 号：R714.245[医药卫生—妇产科学]