子痫前期相关因素分析

Analysis of Related Factors of Preeclampsia

摘要: 目的：初步探讨凝血指标、血小板参数、D-二聚体及肝酶在子痫前期(preeclampsia, PE)临床诊断中的意义并对其相关危险因素作一分析。方法：选取2019年1月至2024年1月于包头医学院第一附属医院住院分娩且符合纳入标准的孕妇作为研究对象，包括病例组95例及对照组49例的临床资料进行分析。运用SPSS 27.0统计软件对研究对象的基线数据与实验室检测指标实施单变量统计分析，筛选存在统计学差异的变量构建回归模型，三组应用多分类Logistic回归分析，筛选出子痫前期发病和影响其严重程度的危险因素，绘制影响PE严重程度危险因素的ROC曲线图。结果：PE发病概率与高龄、初产及高血压家族史有关(p < 0.05)；凝血酶原时间(PT)下降，纤维蛋白原(FIB)、凝血酶时间(TT)、血小板平均体积(MPV)、丙氨酸氨基转移酶(ALT)、乳酸脱氢酶(LDH)升高，都会增加PE的发病概率。PE严重程度与高龄、高血压家族史有关；低水平的PT和高水平的TT、PLT (血小板计数)、MPV、LDH是PE严重程度的因素；PE发病危险因素的ROC曲线图的PT、FIB、TT、PLT、MPV、LHD最佳临界值分别为11.05、4.105、14.05、174.5、187.5、182.5。结论：子痫前期是一组多因素相关性疾病，高龄、高血压病家族史、PT、FIB、TT、PLT、MPV、LHD是病情严重程度的危险因素并对PE的严重程度有预测价值。

Abstract: Objective: To preliminarily explore the significance of coagulation indicators, platelet parameters, D-dimer and liver enzymes in the clinical diagnosis of preeclampsia (PE) and analyze the related risk factors. Methods: Pregnant women who were hospitalized for delivery at the First Affiliated Hospital of Baotou Medical College from January 2019 to January 2024 and met the inclusion criteria were selected as the research subjects. The clinical data of 95 cases in the case group and 49 cases in the control group were analyzed. SPSS 27.0 statistical software was used to conduct univariate statistical analysis of the baseline data and laboratory test indicators of the research subjects, and to screen variables with statistical differences to construct a regression model. Three groups applied multiple classification Logistic regression analysis to screen the risk factors for the onset of PE and its severity. ROC curve diagrams were drawn to illustrate the risk factors affecting the severity of PE. Results: The probability of PE onset was related to advanced age, primiparity and family history of hypertension (p < 0.05); decreased prothrombin time (PT), increased fibrinogen (FIB), thrombin time (TT), mean platelet volume (MPV), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), all increased the probability of PE onset. The severity of PE was related to advanced age and family history of hypertension; low PT and high TT, PLT (platelet count), MPV, LDH were factors affecting the severity of PE; the ROC curve graph of PE risk factors showed that the optimal critical values of PT, FIB, TT, PLT, MPV, LDH were 11.05, 4.105, 14.05, 174.5, 187.5, 182.5, respectively. Conclusion: Preeclampsia is a group of multifactorial related diseases. Advanced age, family history of hypertension, PT, FIB, TT, PLT, MPV, LDH are risk factors for the severity of the disease and have predictive value for the severity of PE.