孕前体质指数联合孕中期母血清学筛查及口服葡萄糖耐量试验对子痫前期的预测价值探讨

摘要

Objective To discuss the prediction value of mid pregnancy pre-body mass index,serological screening and glucose tolerance test for preeclampsia.Methods The clinical data of 1496 cases of pregnant women admitted to the Department of Gynaecology and Obstetrics in our hospital between December 2014 and September 2014 were collected.177 cases of pregnant women who suffered PE were recruited in PE group,and another 177 cases of normal pregnancy were randomly matched as control group,then a comparative analysis was performed on two groups of pregnant women;screening test was carried out for the data of all pregnant women,and the evaluation was conducted for the value of the selected index in the single and combined forecast of PE.Results There was no statistical difference in the age of two groups of pregnant women (P ＞ 0.05).Pre-pregnancy BMI,hCG,AFP,uE3 and OGTT data had statistically significant difference(P ＜0.05).Pre-pregnancy BMI,hCG,OGTT had predictive value of PE (AUC ＞ 0.5);however,AFP,uE3 had no predictive value of PE (AUC ＜0.5).When pre-pregnancy BMI,hCG,2 h-Glu were combined in the forecast of PE,the AUC =0.79,sensitivity was 78.41％,and specificity was 73.38％.Conclusion Joint indicators from different sources can improve the predictive value of preeclampsia.%目的 探讨孕前体质指数(BMI)联合孕中期母血清学筛查及糖耐量试验(OGTT)对子痫前期(PE)的预测价值.方法 收集2014年12月至2016年9月于安徽医科大学第一附属医院妇产科门诊就诊的1 496例孕妇资料,将孕期罹患PE的177例孕妇纳入PE组,随机匹配177例正常妊娠孕妇作为对照组,对两组孕妇资料做比较分析;对所有孕妇资料进行筛检试验,评价所选取的各指标对PE的单项及联合预测价值.结果 两组孕妇年龄差异无统计学意义(P＞0.05);而孕前BMI、人绒毛膜促性腺激素(hCG)、甲胎蛋白(AFP)、游离雌三醇(uE3)及OGTT 3个时间点的血糖差异均有统计学意义(P＜0.05).孕前BMI、hCG和OGTT3个时间点的血糖对PE有预测价值(AUC ＞0.5),AFP、uE3对PE无预测价值(AUC ＜0.5).联合孕前BMI、hCG、2 h-Glu对PE进行预测,AUC=0.79,预测灵敏度为78.41％,特异度为73.38％.结论 联合不同来源的指标可以提高对PE的预测价值.