早发型子痫前期终止妊娠血清学指标的临床研究

于晓红; 赵静; 张翠玲

doi:10.16766/j.cnki.issn.1674-4152.000797

早发型子痫前期终止妊娠血清学指标的临床研究

doi: 10.16766/j.cnki.issn.1674-4152.000797

1. 济宁医学院附属章丘区人民医院妇产科, 山东济南 250200;
2. 济宁医学院附属章丘区人民医院中心实验室;
3. 济南市妇幼保健院质控科, 山东济南 250001

基金项目:

2016年山东省医药卫生科技发展计划项目(2016WS0722)

详细信息

通讯作者:
张翠玲,E-mail:zhangcuiling1111@163.com

中图分类号: R714.244;R446.11
计量
- 文章访问数: 227
- HTML全文浏览量: 27
- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2018-02-12
- 网络出版日期: 2022-08-04

A study on predicting indicators for complicating pregnancy in the pregnancy women with early-onset pre-eclampsia

Department of Gynaecology and Obsterrics, the Zhangqiu District People's Hospital Affiliated to Jining Medical University, Jinan, Shandong 250200, China

摘要

摘要: 目的通过分析血清胱抑素C(CYS-C)、尿酸(UA)、肌酐(CREA)和尿素氮(BUN)数值的变化及相关性，探讨血清胱抑素C(CYS-C)、尿酸(UA)、肌酐(CREA)和尿素氮(BUN)在早发型重度子痫前期终止妊娠中的应用价值。方法选取2015年1月—2016年12月济宁医学院附属章丘区人民医院收治的轻度早发型子痫前期患者64例(轻组)，重度55例(重组)，随机选择同期孕周(28～34周)正常分娩的孕妇55例作为对照组(正常组)，观察血清CYS-C、UA、CREA和BUN水平的变化。结果血清指标各组间差异均有统计学意义(均P<0.01)。ROC曲线最佳临界值CYS-C、UA、CREA和BUN分别为：1.29 mg/L、420.00 μmol/L、59.10 μmol/L、5.94 mmol/L；其灵敏度分别为90.1%、73.4%、68.3%、42.3%；特异度分别为：99.8%、99.8%、88.2%、77.8%；Youden指数最大值分别为89.9%、73.2%、56.5%、20.1%；OR值分别为16.50、1.05、1.25、18.67；r值分别为0.413、0.118、0.345、0.112(均P<0.01)。结论血清CYS-C、UA、CREA和BUN水平随疾病的严重程度升高而升高，它们是独立的危险因素,与子痫前期重度正相关,血清CYS-C与UA、CREA和BUN正相关。CYS-C≥1.29 mg/L、UA≥420.00 μmol/L、CREA≥59.10 μmol/L，BUN≥5.94 mmol/L,可作为早发型子痫前期终止妊娠的血清学指标。血清CYS-C、UA、CREA诊断效能好，BUN诊断效能差，联合检测效果好，经临床综合评估，适时终止妊娠。
- 早发型子痫前期 /
- 终止妊娠 /
- 血清学指标
Abstract: Objective To investigate the significances of Serum cystatin C(CYS-C), Uric Acid (UA), Creatinine (CREA) and Urea Nitrogen (BUN) and the change and correlation of the numerical for complicating pregnancy with early-onset preeclampsia. Methods Total of 64 cases of mild early-onset with preeclampsia (mild group), 55 cases of severe early-onset with preeclampsia (severe group) and 55 cases of healthy pregnant women randomly selected in the same period (28-34 weeks, normal group) admitted in the Zhangqiu District People's Hospital Affiliated to Jining Medical University from January 2015 to December 2016 was enrolled for the study. Results There was no statistical significant difference in age and gestational age (P>0.05). Serum Cystatin C(CYS-C), Uric Acid (UA), Creatinine (CREA) and Urea Nitrogen (BUN) in case group were significantly higher than the control group, differences were all statistical significant (P<0.01). ROC curve indicated that the best critical value of predictors in Early- onset Pre- eclampsia for complicating pregnancy were Serum CYS-C≥1.29 mg/L, UA≥420.00 μmol/L, CREA≥59.10 μmol/L, BUN≥5.94 mmol/L; their sensitivity were 90.1%, 73.4%, 68.3% and 42.3%, respectively; specificity were 99.8%, 99.8%, 88.2%, and 77.8%, respectively; Youden index maximum were 89.9%, 73.2%, 56.5%, and 20.1%, respectively; OR value were 16.50, 1.05, 1.25 and 18.67, respectivel; r value were 0.841, 0.741, 0.751, 0.413, 0.118, 0.345 and 0.112, respectively (all P<0.01). Conclusion Serum CYS-C, UA, CREA and BUN may reflect the progression of the disorder of severity in Early-onset Pre-eclampsia. Serum CYS-C, UA, CREA have best diagnostic efficiency. Serum BUN has poor diagnostic efficiency. There is a positive correlation between them. It is the risk factor respectively and combined the predictors have a higher predictive value. In Sever Early-onset Pre-eclampsia, the number CYS-C≥1.29 mg/L, UA≥420.00 μmol/L, CREA≥59.10 μmol/L, BUN≥5.94 mmol/L, can serve as good indicators for complicating pregnancy. Complicating pregnancy at the right time by clinical comprehensive assessment is necessary.
- Early-onset Pre-eclampsia /
- Complicatingpregnancy /
- Serum predicting indicator