[1]郭彩娇,杨红玲,高 飞,等.孕20周前妊娠期高血压孕妇常规检验指标的新临床意义研究[J].现代检验医学杂志,2018,33(01):95-98.[doi:10.3969/j.issn.1671-7414.2018.01.001]
　GUO Cai-jiao,YANG Hong-ling,GAO Fei,et al.Study on the New Clinical Significance of Routine Indexes in Pregnant Women with HDP before 20 Weeks of Pregnancy[J].Journal of Modern Laboratory Medicine,2018,33(01):95-98.[doi:10.3969/j.issn.1671-7414.2018.01.001]
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孕20周前妊娠期高血压孕妇常规检验指标的新临床意义研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第33卷
期数:
2018年01期
页码:
95-98
栏目:
论著
出版日期:
2018-02-05

文章信息/Info

Title:
Study on the New Clinical Significance of Routine Indexes in Pregnant Women with HDP before 20 Weeks of Pregnancy
文章编号:
1671-7414(2018)01-095-04
作者:
郭彩娇; 杨红玲; 高 飞; 江 敏; 刘云锋; 王洁琳; 陈小娟
广州市妇女儿童医疗中心检验部,广州 510623
Author(s):
GUO Cai-jiao; YANG Hong-ling; GAO Fei; JIANG Min; LIUYun-feng; WANG Jie-lin;  CHEN Xiao-juan
Department of Clinical Laboratory, Guangzhou Women and Children's Medical Centre,Guangzhou 510623,China
关键词:
妊娠期高血压疾病;  生化指标;  凝血指标;  血细胞分析指标
分类号:
R714.246; R446.11
DOI:
10.3969/j.issn.1671-7414.2018.01.001
文献标志码:
A
摘要:
目的 通过孕20周前妊娠期高血压疾病(HDP)孕妇及正常妊娠孕妇的生化、凝血、血细胞计数指标等常规检测项目的对比分析,研究其新临床意义,寻找早期预测HDP的标志物。方法 采用病例对照研究方法,查阅2012～2016年在广州市妇女儿童医疗中心产检并分娩的孕妇的临床资料,按孕周、年龄匹配分为HDP组和对照组,分析两组孕20周前产检的相关检验指标。两组之间的变量采用Kolmogorov-Smirnov进行正态分布性分析,近似正态分布的计量资料数据用均数±标准差((-overx)±s)表示,偏态分布用中位数及百分位数[M(P25～P75)]表示。用Logistic回归模型绘制ROC曲线并计算曲线下面积(AUC),以评价各单项及联合指标的诊断价值。结果 HDP组生化指标AST,γ-GT和UA均高于正常组,差异具有统计学意义(t=2.50,3.34,4.56,均P<0.05); 同时HDP组血细胞计数指标RBC,PLT和HCT均显著高于正常组,差异具有统计学意义(t=3.29,4.51,2.89,均P<0.01)。而两组孕妇其余指标(ALT,TBIL,Cr,Urea,PT,APTT,TT,FIB和HGB)比较,差异无统计学意义(t=0.25～1.85,均P>0.05)。预测Logistic 回归模型:Y=-5.497+0.010*PLT+0.043*γ-GT+0.007*UA+0.045*AST。PLT,γ-GT,UA和AST四个变量联合检测用于预测HDP的敏感度为0.818,特异度为0.523,AUC为0.746。结论 孕20周前,HDP孕妇与正常孕妇相比,肝肾功能受损及血液高凝状态明显,临床上可通过联合检测AST,γ-GT,UA和PLT,提高早期妊娠期高血压疾病诊断效能,优于各单项目检测。
Abstract:
Abstract:Objective To explore the new clinical significance of these routine test indexes and find the early biomarkers for predicting hypertension disorder complicating pregnancy(HDP)by the comparative analysis between pregnant women with HDP and normal pregnant women before 20 weeks,including biochemical,blood coagulation and blood routine indexes.MethodsA case-control study was conducted to review the clinical data of pregnant women who were undertaken prenatal examination and delivered in GuangzhouWomen and Children's Medical Center from 2012 to 2016.The pregnancy were divided into HDP group and control group according to the gestational week and age.Analyzed the related test indexes before 20 weeks of pregnancy.The two groups variables were analyzed by Kolmogorov-Smirnov for normal distribution.Approximate measurement data of normal distribution were mean±standard deviation((-overx)±s)for statistical description,while the data of the skewed distribution was median and percentile[M(P25～P75)]for statistical description.The diagnostic value was analyzed by logistic regression equation and receiver operatingcharacteristic curves(ROC).Results The level of biochemical indexes(AST,γ-GT and UA)of HDP group was significantly higher than the normal group(t=2.50,3.34,4.56,P<0.05).Meanwhile the level of blood indexes(RBC,PLT and HCT)of HDP group was significantly higher than the normal group(t=2.89,4.51,3.29,all P<0.01).Other indicators of twogroups(ALT,TBIL,Cr,Urea,PT,APTT,TT,FIB and HGB)were not significantlydifferent(t=0.25～1.85,all P>0.05).Then the logistic regression model equation was Y=-5.497+0.010*PLT+0.043*γ-GT+0.007*UA+0.045*AST.The area under ROC curve(AUC)was 0.746 for the combination of the four indexes.The combination resulted in a higher sensitivity of 0.818 and specificity of0.523.Conclusion Before 20 weeks of gestation,compared with normal group,liver and kidney function in patients with HDP and high blood coagulation state was damaged.Can by combined detection of AST,UA,γ-GT and PLT index,early prevention and diagnosis of gestational hypertension,effective intervention measures taken as soon as possible to improve the prognosis ofpregnancy.

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备注/Memo

备注/Memo:
基金项目:广东省医学科研基金(C2017024)。 作者简介:郭彩娇(1963-),女,学士,副主任技师,主要从事临床免疫检验工作,E-mail:monicag@126.com。 通讯作者:杨红玲(1961-),女,博士,主任医师,主要从事临床检验诊断学工作,E-mail:hlyang62@163.com。
更新日期/Last Update: 2018-02-07