改良休克指数与妊娠期高血压病患者产后出血相关性研究

Study of relationship between MSI and postpartum hemorrhage in patients with HDP

目的探讨改良休克指数(MSI)在妊娠期高血压患者产后出血的相关性及应用.方法根据妊娠期高血压患者是否发生产后出血进行分组比较,使用诊断时MSI对产后出血进行预测,以ROC曲线验证预测模型区分度.结果1381例中共64例患者出现产后出血.两组患者年龄、临床诊断、疾病严重程度、分娩孕周、BMI及产次的差异均无统计学意义(P>0.05).并发症及合并症,产后出血组仅中央性前置胎盘发生率高于无产后出血组(P<0.05).产后出血组MSI高于无产后出血组(0.91±0.12vs.0.87±0.13,P=0.006),校正混杂因素后MSI是产后出血独立危险因素.3个预测模型ROC曲线下面积分别为0.744、0.758及0.772.结论诊断妊娠期高血压病时的MSI对于患者产后出血具有预警作用.

Objective To explore the correlation and application of MSI in postpartum hemorrhage with HDP.Methods According to the occurrence of postpartum hemorrhage in GHD.the postpartum hemorrhage was predicted by MSI.and the model differentiation was verified by ROC curve.Results A total of 64 patients had postpartum hemorrhage.There was no statistical difference in age.disease severity,gestational age.BMI and parity between the two groups.Only the incidence of central placenta previa in the postpartum hemorrhage group was higher than that in the control group(P<0.05).The MSI in the postpartum hemorrhage group was higher.It was suggested that MSI was an independent risk factor for postpartum hemorrhage.The AUC of the three prediction models were 0.744.0.758 and 0.772 respectively.Conclusion MSI in the diagnosis of HDP has an early warning effect on postpartum hemorrhage.