贵州医科大学学报

2020, v.45;No.232(01) 67-71

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外周血Hb及PLGF和PI联合检测对早发型子痫前期孕妇再妊娠的诊断价值
The Diagnostic Value of Peripheral Blood Hb,PLGF and PI Combined Detection on Repregnancy of Preeclampsia Pregnant Women with Early Onset

王茜,赵金珩,李娟,贾燚鑫,桑雪梅,谢君怡然,孙丽君,杨清
WANG Qian,ZHAO Jinhang,LI Juan,JIA Yixin,SANG Xuemei,XIE Junyiran,SUN Lijun,YANG Qing

摘要(Abstract):

目的:探讨外周血血红蛋白(Hb)、胎盘生长因子(PLGF)及子宫动脉搏动指数(PI)联合检测对早发型子痫前期(PE)孕妇再妊娠PE发生的早期诊断价值,观察小剂量阿司匹林抗凝治疗对早发型PE孕妇再妊娠的临床效果。方法:80例首次妊娠确诊为早发型PE并再次分娩的经产孕妇作为实验组,80例经产孕妇作为对照组;实验组再均分为A组及B组,于孕13周时A组采用小剂量阿司匹林治疗、B组孕妇采取口服白色肠溶淀粉片剂治疗,疗程6周;2组孕妇均于孕12周时测定血清Hb、PLGF浓度及测量PI值,比较单一指标检测及3项指标联合检测对早发型PE的检出率、假阳性率、特异度、敏感度及受试者工作特征(ROC)曲线下面积(AUC),比较治疗后实验A、B组孕妇的早发型PE、晚发型PE、重度PE、轻度PE的再发率及PE总再发率,比较治疗后实验A、B组孕妇胎盘早剥、肝肾功能损害、产后出血发生率及婴儿死亡、破宫产、早产、低体重儿发生率。结果:实验组孕妇外周血Hb和PLGF浓度显著低于对照组,PI值显著高于对照组,差异有统计学意义(P<0.05);Hb、PLGF及PI联合检测对早发型PE的检出率、特异度、敏感度、AUC值均显著高于各单一指标检测,而假阳性率显著低于各单一指标检测;治疗后,实验A组孕妇早发型PE、晚发型PE、重度PE及总再发率,孕妇胎盘早剥、肝肾功能损害发生率及婴儿破宫产率、早产率、低体重儿发生率显著低于实验B组,差异有统计学意义(P<0.05)。结论:PLGF、Hb及PI联合检测能提高PE发生的早期诊断,小剂量阿司匹林能改善PE孕妇和婴儿的围生结局。
Objective: To study the diagnostic value of combined detection of fetal hemoglobin(Hb),placental growth factor(PLGF),uterine artery pulsatile index(PI) and the clinical effect of low dose aspirin anticoagulant therapy in early pregnancy of(PE) pregnant women with early onset preeclampsia.Methods: 80 pregnant women with early onset of PE were selected into the experimental group from April 2016 to April 2018 in our hospital,and 80 healthy pregnant women with healthy pregnancy during the same period were selected into the control group.The differences of serum Hb concentration,PLGF concentration and Pi value between the two groups were compared.The detection rate and false positive rate of PE predicted by single factor and multiple factors were compared,and the specificity,sensitivity and AUC value of each index were described under ROC curve.The experimental group was randomly divided into group A and group B(n=40 each).The patients were treated with low dose aspirin prophylaxis and placebo at the 13 th week of gestation.The incidence and outcome of maternal and infant related complications in the two groups were followed up.Results:The serum Hb and PLGF concentrations of pregnant women in the experimental group were significantly lower than those in the control group,and the PI values were significantly higher than those in the control group(P<0.05).PLGF,Hb and PI were significantly higher than those in the control group.The detection rate,sensitivity,specificity and AUC of combined detection were significantly higher than that of single factor prediction(P<0.05),and the false positive rate was significantly lower than that of single factor(P<0.05).Compared with group B(P<0.05),there was no significant difference between the two groups(P>0.05).The incidence of placental abruption,liver and kidney function of group A and the premature birth of the baby were significantly lower than that in group B(P<0.05).The incidence of low-weight infants was significantly lower than that in group B(P<0.05).Conclusion: The combination of PLGF,Hb and PI and the prevention and treatment of low-dose aspirin can significantly improve the clinical management of early-onset pre-eclampsia and have a great value for popularization and application.

关键词(KeyWords): 早发型子痫前期;再次妊娠;早期预测;早期干预
early onset preeclampsia;repregnancy;early prediction;early intervention

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81872125);; 河北省卫生厅科研基金项目(20171330)

作者(Author): 王茜,赵金珩,李娟,贾燚鑫,桑雪梅,谢君怡然,孙丽君,杨清
WANG Qian,ZHAO Jinhang,LI Juan,JIA Yixin,SANG Xuemei,XIE Junyiran,SUN Lijun,YANG Qing

DOI: 10.19367/j.cnki.1000-2707.2020.01.013

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