LMR、β-HCG、D-D与妊娠期高血压疾病严重程度及妊娠结局的相关性研究

Correlation of LMR、β-hCG,D-D with the Severity of Hypertensive Disorders of Pregnancy and Pregnancy Outcomes

目的探究淋巴细胞与单核细胞比值(LMR)、血清β-人绒毛膜促性腺激素(β-HCG)、D-二聚体(D-D)与妊娠期高血压疾病(HDCP)严重程度相关性,并分析以上指标对妊娠结局的预测作用。方法选取我院妇产科诊治的150例患者作为研究对象,根据疾病发展程度分为妊娠高血压组、轻度子痫前期组(轻度组)、重度子痫前期组(重度组)。于孕20周检测患者LMR、β-HCG、D-D表达水平,分析LMR、β-HCG、D-D与HDCP严重程度的相关性,同时记录患者的妊娠结局。结果3组的LMR、β-HCG、D-D表达水平均存在显著差异,其中以妊娠高血压组最低,轻度组次之,重度组最高(P<0.05)。根据Pearson相关性分析显示,LMR、β-HCG、D-D水平与HDCP患者疾病程度呈正相关(r=0.315、0.630、0.376,P<0.05)。150例HDCP患者中不良妊娠结局27例,其中早产16例、死胎1例、新生儿窒息4例、宫内窘迫6例。根据ROC曲线结果显示,LMR、β-HCG、D-D联合预测的曲线下面积(AUC)明显高于LMR、β-HCG、D-D单独预测,其敏感度为85.7%,特异度为78.7%。结论LMR、β-HCG、D-D水平与HDCP存在相关性,同时检测对于其不良妊娠结局具有一定的预测价值。

Objective To explore the correlation between lymphocyte to monocyte ratio(LMR),serumβ-Human chorionic gonadotropin(β-HCG),D-Dimer(D-D)and the severity of hypertensive disorders of pregnancy(HDCP),and the predictive effect of the above indexes on pregnancy outcomes.Methods 150 patients with gestational hypertension diagnosed and treated in the obstetrics and gynecology department of our hospital from September 2019 to June 2021 were selected as the research objects.According to the degree of disease development,they were divided into gestational hypertension group,mild preeclampsia group(mild group)and severe preeclampsia group(severe group).The expression levels of LMR,β-HCG and D-D were detected at 20 weeks of gestation,and the correlation between LMR,β-HCG,D-D and the severity of gestational hypertension was analyzed,and the pregnancy outcomes of the patients were recorded.Results There were significant differences in the levels of LMR,β-HCG and D-D among the three groups,among which the gestational hypertension group was the lowest,the mild group was the second,and the severe group was the highest(P<0.05).According to Pearson correlation analysis,LMR,β-HCG,D-D levels were positively correlated with the degree of disease in HDCP patients(r=0.315,0.630,0.376,P<0.05).In this study,there were 27 cases of adverse pregnancy outcomes in 150 patients with gestational hypertension,including 16 premature births,1 stillbirth,4 neonatal asphyxia,and 6 intrauterine distress.According to the ROC curve results,the area under the curve(AUC)of the combined prediction of LMR,β-HCG,and D-D was significantly higher than that of LMR,β-HCG,and D-D alone,with a sensitivity of 85.7%and a specificity of 78.7%.Conclusion The levels of LMR、β-hCG and D-D are correlated with gestational hypertension,and their detection has a certain predictive value for adverse pregnancy outcomes.