子痫前期孕妇D-二聚体水平与中性粒细胞与淋巴细胞比值的相关性探究

Correlation between D-dimer level and neutrophil-to-lymphocyte ratio in pregnant women with preeclampsia

目的分析子痫前期孕妇D-二聚体水平与中性粒细胞与淋巴细胞比值(NLR)的相关性。方法回顾性分析临床资料,选择2021年1月至12月于我院收治的子痫前期孕妇80例为观察对象,纳为子痫前期组,根据病情严重程度分为轻度组(42例)、重度组(38例),同期选择于我院产检的健康孕妇80名为健康对象组,采集各组孕妇空腹静脉血,比较各组孕妇血浆D-二聚体水平、NLR水平,查阅2组孕妇产后新生儿临床资料,比较各组新生儿体质量、1 min Apgar评分、5 min Apgar评分。采用Pearson相关性分析D-二聚体水平与NLR及其他指标相关性;采用受试者工作特征(ROC)曲线评估D-二聚体、NLR预测子痫前期发生的价值。结果子痫前期组孕妇血浆D-二聚体水平及NLR水平高于健康对照组(P<0.05)。重度组孕妇血浆D-二聚体水平及NLR水平高于轻度组(P<0.05)。重度组新生儿体质量低于轻度组,1min Apgar评分、5min Apgar评分低于轻度组(P<0.05)。子痫前期Pearson相关性分析显示,子痫前期孕妇血浆D-二聚体水平与NLR呈明显正相关(r=0.52,P<0.05),与新生儿体质量、1min Apgar评分、5min Apgar评分呈明显负相关(r=-0.47、-0.51、-0.45,P均<0.05)。ROC曲线显示,D-二聚体、NLR预测子痫前期发生的曲线下面积(AUC)分别为0.733、0.803,联合预测的AUC为0.906,联合预测价值较高。结论子痫前期孕妇普遍存在凝血功能异常情况,D-二聚体水平明显异常表达,且D-二聚体水平与子痫前期病情严重程度及NLR水平存在一定相关性,定期监测D-二聚体水平变化有助于评估病情,为临床治疗及预后预测提供合理参考。

Objective To analyze the correlation between D-dimer(D-D)level and neutrophil to lymphocyte ratio(NLR)in pregnant women with preeclampsia.Methods Clinical data were analyzed retrospectively,and 80 pregnant women with preeclampsia admitted to our hospital from January 2021 to December 2021 were selected for observation.All the patients were divided into preeclampsia group,and according to the severity of the disease,they were classified into the mild group(n=42)and the severe group(n=38),and 80 healthy pregnant women who had their labor checkups at the same period were selected as the healthy subject group.Fasting venous blood was collected from pregnant women in each group,and plasma D-D levels and NLR levels were compared between the groups.Clinical data of postpartum newborns in the two groups were reviewed,and body mass,1 min Apgar score,and 5 min Apgar score of newborns in each group were compared.Pearson correlation analysis was used to analyze the correlation between D-D level and NLR and other indexes.The value of D-D and NLR in predicting the occurrence of preeclampsia was evaluated by using the subject′s work characteristics(ROC)curve.Results Plasma D-D levels and NLR levels of pregnant women in the preeclampsia group were higher than those in the healthy control group(P<0.05).Plasma D-D levels and NLR levels of pregnant women in the severe group were higher than those in the mild group(P<0.05).The body mass of newborns in the severe group was lower than that in the mild group,and the 1 min Apgar score and 5 min Apgar score were lower than those in the mild group(P<0.05).Pearson correlation analysis in preeclampsia showed that plasma D-D levels in pregnant women with preeclampsia were significantly positively correlated with NLR(r=0.52,P<0.05),and significantly negatively correlated with neonatal body mass,1min Apgar score,and 5 min Apgar score(r=-0.47,-0.51,-0.45,P<0.05).The ROC curve showed that the area under the curve(AUC)of D-D and NLR for predicting the occurrence of preeclampsia were 0.733 and 0.803,respectively,and the AUC of the combined prediction was 0.906,which was of high predictive value.Conclusion Preeclamptic pregnant women generally have abnormal coagulation function,and the D-D level is abnormally expressed.There is a certain correlation between D-D level and the severity of preeclampsia and the NLR level,so regular monitoring of the changes in the level of D-D is helpful for the assessment of the condition,and it can provide a reasonable reference for the clinical treatment and the prediction of the prognosis.