妊娠高危病史联合血清胎盘生长因子和25羟维生素D预测子痫前期的价值  

Values of high-risk pregnancy history combined with serum placental growth factor and 25-hydroxy vitamin D in predicting pre-eclampsia

作　　者：王振辉 刘骏 杨丽勤 WANG Zhenhui;LIU Jun;YANG Liqin(Hunan Provincial Maternal and Child Health Hospital,Changsha,Hunan 410008,China)

机构地区：[1]湖南省妇幼保健院,湖南长沙410008

出　　处：《实用预防医学》2024年第8期917-920,共4页Practical Preventive Medicine

基　　金：湖南省自然科学基金(2019JJ50297)。

摘　　要：目的 探讨孕早期妊娠高危病史联合胎盘生长因子(placental growth factor, PLGF)、25羟维生素D[25-hydroxy vitamin D,25-(OH)VitD]预测子痫前期的价值。方法 回顾性选取2019年1月—2021年12月孕11+0~13+6周进行产前检查并在该院分娩的362例孕妇纳入研究,分析妊娠高危病史、血清PLGF和25-(OH)VitD与子痫前期发生的相关性,评价其对子痫前期的预测价值。结果 共纳入362例孕妇,其中106例(29.28%)发生子痫前期。有妊娠高危病史、PLGF≤39 pg/ml、25-(OH)VitD<30 ng/ml的孕妇发生子痫前期的比例更高,差异均有统计学意义(P<0.001)。logisitc回归分析结果显示,相较于无妊娠高危病史、PLGF>39 pg/ml和25-(OH)VitD≥30 ng/ml,有妊娠高危病史(OR=3.219,95%CI:2.045~5.066)、PLGF≤39 pg/ml(OR=2.621,95%CI:1.635~4.200)、25-(OH)VitD<30 ng/ml(OR=13.417,95%CI:8.173~22.024,P=0.000)的孕妇发生子痫前期的风险较高。受试者工作特征(receiver operator characteristic, ROC)曲线结果显示,妊娠高危病史、PLGF、25-(OH)VitD水平对子痫前期的发生均具有预测效能,而三者联合检测预测效能高于单独检测,灵敏度为81.8%,特异度为69.7%,约登指数为0.515。结论 妊娠高危病史、PLGF、25-(OH)VitD各指标对子痫前期发病均有预测价值,联合检测预测价值要优于任一单项指标。Objective To explore the values of high-risk pregnancy history combined with placental growth factor(PLGF)and 25-hydroxy vitamin D(25-OH-VD)in predicting pre-eclampsia(PE)in the first trimester.Methods We retrospectively selected 362 pregnant women who underwent prenatal examination at 11+0-13+6 weeks of gestation and delivered in Hunan Provincial Maternal and Child Health Hospital from January 2019 to December 2021,and then they were enrolled in the study.The correlations of high-risk pregnancy history,serum PLGF and 25-OH-VD with the occurrence of PE were analyzed,and their predictive values for PE were evaluated.Results A total of 362 pregnant women were enrolled in the study,106(29.28%)of whom developed PE.PE was more common in pregnant women with high-risk pregnancy history,PLGF≤39 pg/ml and 25-OH-VD<30 ng/ml,and the differences were statistically significant(all P<0.001).Logistic regression analysis displayed that pregnant women with high-risk pregnancy history(OR=3.219,95%CI:2.045-5.066),PLGF≤39 pg/ml(OR=2.621,95%CI:1.635-4.200)and 25-OH-VD<30 ng/ml(OR=13.417,95%CI:8.173-22.024,P=0.000)had a higher risk of occurrence of PEcompared with those without high-risk pregnancy history,with PLGF>39 pg/ml and 25-OH-VD≥30 ng/ml.The results ofreceiver operator characteristic(ROC)curve revealed that high-risk pregnancy history,PLGF and 25-OH-VD levels all had predictive efficacy on the occurrence of PE,and the predictive efficacy of combined detection of the above-mentioned three indexes was higher than that of the single index detection,with the sensitivity being 81.8%,the specificity being 69.7%and the Youden index being 0.515.Conclusion High-risk pregnancy history,PLGF and 25-OH-VD all have predictive values for the onset of PE,and the predictive value of the combined detection is superior to any single index detection.

关 键 词：子痫前期 妊娠高危病史 胎盘生长因子 25羟维生素D 预测 

分 类 号：R714.244[医药卫生—妇产科学]