血小板参数及凝血指标对子痫前期的预测价值

Predictive value of platelet parameters and coagulation indexes for preeclampsia

目的探讨血小板参数及凝血指标对子痫前期的预测价值。方法检测子痫前期孕妇162例(子痫前期组)及正常健康体检孕妇113例(对照组)的收缩压、舒张压、24-h尿蛋白、血小板参数和凝血指标,采用ROC曲线分析24-h尿蛋白、血小板参数和凝血指标对子痫前期的预测价值。结果子痫前期组收缩压、舒张压、24-h尿蛋白、平均血小板体积(MPV)、血小板分布宽度(PDW)、APTT、凝血酶时间(TT)高于对照组,凝血酶原时间(PT)低于对照组(P<0.05)。ROC曲线分析发现,24-h尿蛋白、MPV、PDW、APTT、TT、PT预测子痫前期的AUC分别为0.879、0.611、0.820、0.704、0.657、0.621。联合PDW、APTT和TT预测子痫前期的AUC为0.890,当截断值取33.360时,预测子痫前期的灵敏度和特异度分别为83.0%和81.8%;联合PDW、24-h尿蛋白和APTT预测子痫前期的AUC为0.917,当截断值取35.625时,预测子痫前期的灵敏度和特异度分别为80.5%和86.4%。结论24-h尿蛋白、MPV、PDW、APTT、TT和PT可用于预测子痫前期,联合多项指标较单一指标的预测价值更高。

Objective To investigate the predictive value of platelet parameters and coagulation indexes for preeclampsia.Methods The diastolic and systolic blood pressures,24-h urinary protein,platelet parameters and coagulation indexes were detected in 162 pregnant women with preeclampsia(group A)and 113 healthy pregnant women(group C).ROC curve was used to analyze the predictive value of 24-h urinary protein,platelet parameters and coagulation indexes for preeclampsia.ResultsThe diastolic and systolic blood pressures,24-h urinary protein,mean platelet volume(MPV),platelet distribution width(PDW),activated partial thromboplastin time(APTT)and thrombin time(TT)were higher and prothrombin time(PT)was lower in group A than those in group C(P<0.05).ROC curve analysis showed that the AUC values of 24-h urinary protein,MPV,PDW,APTT,TT and PT for predicting the preeclampsia were 0.879,0.611,0.820,0.704,0.657 and 0.621,respectively.The AUC of combination of PDW,APTT and TT in predicting the preeclampsia was 0.890.When the cutoff value was 33.360,the sensitivity and specificity of combined detection of PDW,APTT and TT in predicting the preeclampsia were 83.0%and 81.8%,respectively.The AUC of combined detection of PDW,24-h urinary protein and APTT in predicting the preeclampsia was 0.917.When the cutoff value was 35.625,the sensitivity and specificity of combined detection of PDW,24-h urinary protein and APTT in predicting the preeclampsia were 80.5%and 86.4%,respectively.Conclusion The 24-h urinary protein,MPV,PDW,APTT,TT and PT can be used to predict the preeclampsia.Combined detection of multiple indicators has higher predictive value than single indicator.