摘要
目的探讨血清胱抑素C(Cys C)、血小板(PLT)与红细胞体积分布宽度(RDW)联合检测在妊娠期高血压(HDP)诊断的临床意义。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Cys C、PLT及RDW的水平。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组血清门冬酸氨基转移酶、总胆汁酸、Cys C、PLT及RDW均高于正常组,差异有统计学意义(t=2.50、2.38、7.78、4.51、5.12,P均<0.05)。预测Logistic回归模型:Y=-11.927+0.017*PLT+0.338*RDW+4.728*Cys C。Cys C、PLT、RDW 3个变量联合检测用于预测HDP的敏感度为0.84,特异性为0.78,AUC为0.848,高于各指标单项检测的AUC(分别为0.744、0.654和0.682)。Pearson相关性分析显示,Cys C与RDW呈弱负相关(r=-0.24,P<0.01)。结论孕20周前,血清Cys C、PLT及RDW联合检测有助于提高早期妊娠期高血压诊断效能,优于各单项目检测。
Objective To explore the clinical significance of combined detection of serum cystatin C(Cys C),blood platelet(PLT)and red blood cell distribution width(RDW)in the diagnosis of hypertension disorders complicating pregnancy(HDP).Methods A case-control study was conducted to review the clinical data of pregnant women who were undertaken prenatal examination and delivered in Guangzhou women and children′s medical center from 2012 to 2016.The pregnancy divided into HDP group and control group according to the gestational week and age.The levels of Cys C,PLT and RDW were analyzed before 20 weeks of pregnancy.The diagnostic value was analyzed by logistic regression equation and receiver operating characteristic curves(ROC).Results The level of indexes(AST,TBA,Cys C,PLT,RDW)of HDP group was significantly higher than those of the normal group(t=2.50,2.38,7.78,4.51,5.12;P<0.05,P<0.05,P<0.01,P<0.01,P<0.01,respectively).The logistic regression model equation was Y=-11.927+0.017*PLT+0.338*RDW+4.728* Cys C.The area under ROC curve(AUC)was 0.848 for the combination of the three indexes and was higher than that of any single index.The combination resulted with a sensitivity of 0.84 and specificity of 0.78.Person correlation analysis showed Cys C was weakly and negatively associated with RDW(r=-0.24,P<0.01).Conclusion Before 20 weeks of gestation,the combined detection of Cys C,PLT and RDW is superior to a single index detection,which can significantly improve diagnostic efficiency for early HDP.
引文
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