妊娠期妇女脂溶性维生素水平对子痫前期的预测价值

The predictive value of fat-soluble vitamins for pre-eclampsia in pregnant women

目的探讨脂溶性维生素对妊娠期妇女子痫前期的预测价值。方法选取2017年7月-2018年11月在该院进行产前检查的妊娠期妇女189例,其中子痫前期82例(子痫前期组),妊娠期高血压疾病107例(妊娠期高血压疾病组),另选取同期的正常妊娠妇女205例(正常妊娠组)。采用超高效液相色谱-串联质谱法(UPLC-MS/MS)测定所有研究对象血清维生素A、1,25-(OH)2D3、维生素E和维生素K1的水平,比较3组上述指标的差异。采用受试者工作特征(ROC)曲线评价脂溶性维生素对子痫前期的预测价值。结果 3组间妇女年龄、体质指数(BMI)、孕周、妊娠次数比较,差异均无统计学意义(均P>0. 05)。与正常妊娠组相比,妊娠期高血压疾病组和子痫前期组维生素E和维生素K1水平明显升高(均P<0. 05),妊娠期高血压疾病组和子痫前期组上述指标比较,差异均无统计学意义(均P>0. 05)。3组间维生素A和1,25-(OH)2D3水平比较,差异均无统计学意义(均P>0. 05)。维生素A、1,25-(OH)2D3、维生素E、维生素K1预测子痫前期ROC曲线下面积分别是0. 527、0. 523、0. 563和0. 618,相应的诊断临界值分别为479. 11μg/ml (灵敏度为87. 71%,特异度为30. 77%)、12. 68 ng/ml(灵敏度为20. 73%,特异度为88. 78%)、10. 46μg/ml (灵敏度为59. 76%,特异度为53. 85%)和0. 58 ng/ml (灵敏度为76. 83%,特异度为48. 29%)。结论妊娠期妇女脂溶性维生素水平尚不能用于预测子痫前期的发病。

Objective To investigate the predictive value of fat-soluble vitamins of pre-eclampsia in pregnant women. Methods The pregnant women who underwent prenatal examinations in our hospital were from July 2017 to November 2018 were selected in this study. Including 82 cases of pre-eclampsia( pre-eclampsia group),107 cases of gestational hypertension( gestational hypertension group) and 205 cases of normal pregnant women( normal pregnancy group). Serum levels of vitamin A,1,25-(OH)2D3,vitamin E and vitamin K1 were determined by high performance liquid chromatography-tandem mass spectrometry UPLC-MS/MS. The predictive value of fat-soluble vitamins in preeclampsia was evaluated by receiver operating characteristic( ROC) curve. Results There was no significant difference in age,body mass index( BMI),gestational age and gestational frequency between the three groups. Compared with the normal pregnancy group,the levels of vitamin E and vitamin K1 in the Gestational hypertension and the preeclampsia group were significantly increased( P<0. 05),and there was no statistically significant difference in the above indicators between the Gestational hypertension and the preeclampsia group( P>0. 05). There was no significant difference in the levels of vitamin A and 1,25-(OH)2D3 between the three groups( P>0. 05). The area under the ROC curve( AUC) of vitamin A,D3,E and K1 were 0. 527,0. 523,0. 563 and 0. 618,respectively. And the corresponding cut-off value were 479. 11 μg/ml( sensitivity 87. 71%,specificity 30. 77%),12. 68 ng/ml( sensitivity 20. 73%,specificity was88. 78%),respectively,10. 46 μg/ml( sensitivity 59. 76%, specificity 53. 85%) and 0. 58 ng/ml( sensitivity 76. 83%, specificity48. 29%). Conclusion The value of fat-soluble vitamins in predicting preeclampsia in pregnant women is limited.