血清NLR、PLR在子痫前期孕妇中的表达及其与血压、24 h尿蛋白、围产结局的关系  

Expression of serum NLR and PLR in pregnant women with preeclampsia and their relationship with blood pressure,24 h urine protein,and perinatal outcomes

作　　者：朱文丽 娄艳慧 赵玉玲 Zhu Wenli;Lou Yanhui;Zhao Yuling(Department of Obstetrics,Chengde Central Hospital,Hebei,Chengde 067000,China)

机构地区：[1]承德市中心医院产科,河北承德067000

出　　处：《发育医学电子杂志》2025年第2期128-132,共5页Journal of Developmental Medicine (Electronic Version)

基　　金：河北省医学科学研究课题计划(20170883);承德市科技支撑计划项目(202102A014)。

摘　　要：目的探讨子痫前期孕妇血清中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)的表达水平,并分析两者与血压、24 h尿蛋白、围产结局的关系。方法采用前瞻性研究方法,选取2018年9月至2021年9月承德市中心医院收治的187例子痫前期孕妇(子痫前期组)、177例重度子痫前期孕妇(重度子痫前期组)与190例正常分娩孕妇(对照组)为研究对象,收集3组的临床资料及实验室检查结果,分析血清NLR和PLR表达水平与子痫前期孕妇血压、24 h尿蛋白及5 min Apgar评分、新生儿出生体质量、胎盘质量的相关性,并探讨两者对子痫前期的诊断价值。统计学方法采用单因素方差分析,LSD-t检验、Pearson相关性分析、受试者操作特征曲线分析。结果重度子痫前期组孕妇血清PLR、5 min Apgar评分、新生儿出生体质量、胎盘质量均低于子痫前期组及对照组,NLR、收缩压、舒张压、24 h尿蛋白均高于子痫前期组及对照组,差异均有统计学意义(P值均<0.05)。血清NLR和PLR表达水平与收缩压、舒张压、24 h尿蛋白、5 min Apgar评分、新生儿出生体质量、胎盘质量均相关(P值均<0.05)。血清NLR、PLR诊断子痫前期效能的曲线下面积(area under the curve,AUC)分别为0.732、0.701(P>0.05);且当NLR表达水平>3.73,PLR表达水平<113.24时,血清NLR和PLR的敏感度分别为68.25%、74.62%,特异度分别为75.92%、65.79%,两者联合检测诊断子痫前期的AUC、敏感度、特异度分别为0.897、91.02%、82.57%,较单一指标诊断价值明显提升(P<0.05)。结论子痫前期孕妇血清PLR表达水平明显下降,NLR表达水平明显上调,与血压、24 h尿蛋白、围产结局有明显相关性;两者联合检测可进一步提高子痫前期的诊断准确率。Objective To explore the expression levels of serum neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in pregnant women with preeclampsia,and analyze their relationship with blood pressure,24 h urine protein,and perinatal outcomes.Method Using prospective study methods,187 pregnant women with preeclampsia(preeclampsia group),177 pregnant women with severe preeclampsia(severe preeclampsia group),and 190 pregnant women with normal delivery(control group)admitted to Chengde Central Hospital from September 2018 to September 2021 were selected as the research subjects,the clinical data and laboratory test results of 3 groups were collected,and the correlation of serum NLR and PLR expression levels with blood pressure,24 h urine protein and 5 min Apgar score,neonatal birth weight,and placental weight in preeclampsia patients were analyzed,and the diagnosis value of both for preeclampsia was also explored.The Statistical methods performed by one-way analysis of variance,LSD-t test,Pearson correlation analysis and receiver operating characteristic curve analysis.Result The serum PLR,5 min Apgar score,neonatal birth weight and placental weight in the severe preeclampsia group were lower than those in the preeclampsia group and the control group,and the NLR,systolic blood pressure,diastolic blood pressure and 24 h urine protein were higher than those in the preeclampsia group and the control group,the differences were statistically significant(all P<0.05).The expression levels of serum NLR and PLR were correlated with systolic blood pressure,diastolic blood pressure,24 h urine protein,5 min Apgar score,newborn birth weight,and placental weight(all P<0.05).The area under the curve(AUC)of serum NLR and PLR in the diagnosis of preeclampsia were 0.732 and 0.701,respectively(P>0.05),when the expression level of NLR was>3.73 and the expression level of PLR was<113.24,the sensitivity of serum NLR and PLR were 68.25%and 74.62%,respectively,and the specificity were 75.92%and 65.79%,respectively.The AUC,sensiti

关 键 词：子痫前期 分泌性血管内皮生长因子 中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 血压 尿蛋白 相关性 诊断 

分 类 号：R71[医药卫生—妇产科学]