中性粒细胞–淋巴细胞比值、血小板计数–淋巴细胞比值在子痫前期风险预警中的价值

The Value of Neutrophil-to-Lymphocyte Ratio and Platelet Count-to-Lymphocyte Ratio in Preeclampsia Risk Prediction

目的:对比分析子痫前期患者正常妊娠女性中性粒细胞–淋巴细胞比值与血小板–淋巴细胞比值的变化,探讨中性粒细胞–淋巴细胞比值和血小板–淋巴细胞比值在子痫前期风险预警中的价值。方法:选取我院2022年4月~2023年9月妇产科住院分娩的464名孕妇进行研究,其中有372例孕妇为正常妊娠孕妇,92例为子痫前期患者,分为正常妊娠组和子痫前期组。分别计算两组受试者NLR与PLR数值,比较两组数值的变化,经Logistic回归分析,检验NLR与PLR在子痫前期中预测判断的临床价值,评估子痫前期危险因素。结果:正常妊娠组与子痫前期组NLR、PLR水平比较存有明显差异,子痫前期组NLR水平明显高于正常妊娠组,PLR水平明显低于正常妊娠组,差异具有统计学意义(P < 0.05);对比不同孕期,NLR、PLR与子痫前期严重程度、孕妇年龄及孕前体质量指数均无关;ROC曲线下NLR预测子痫前期面积为0.725,最佳临界值为4.28,灵敏度和特异度分别为55.4%和78.3%;PLR预测子痫前期面积为0.68,最佳临界值为122.78,灵敏度和特异度分别为68.4%和60.3%,NLR ≥ 4.30,PLR ≤ 122.75,两项指标均为子痫前期预测独立危险因素,量指标联合预测AUC为0.854,最佳临界值为4.28,灵敏度与特异度分别为74.3%和88.4%。结论:NLR、PLR作为非特异性系统验证指标,与子痫前期具有一定的相关性,可用于子痫前期预测和评估,有助于评估子痫前期疾病进展情况与严重程度,具有风险预警的价值,值得临床推广应用。

Objective: To compare the changes of neutrophil-lymphocyte ratio in normal pregnant women, and explore the value of neutrophil-lymphocyte ratio in the risk warning of preeclampsia. Methods: 464 pregnant women were born in obstetrics and gynecology from April 2022 to September 2023, among which 372 were normal pregnant women and 92 were preeclampsia patients, which were divided into normal pregnancy group and preeclampsia group. Calculate the NLR and PLR values in two groups, compare the changes in the values, test the clinical value of NLR and PLR in preeclampsia and evaluate the risk factors of preeclampsia by Logistic regression analysis. Results: NLR and PLR levels were significantly different between normal pregnancy and preeclampsia, the NLR levels were significantly higher in the preeclamptic group than in the normal pregnancy group, PLR levels were significantly lower than that in the normal pregnancy group, the difference is statistically significant (P < 0.05);Comparing the different pregnancies, NLR and PLR were not associated with the severity of preeclampsia, maternal age, and pregnancy mass index;NLR under the ROC curve predicted the area of preeclampsia of 0.725, the optimal cut-off value was 4.28, sensitivity and specificity were 55.4% and 78.3%, respectively;The PLR predicted the area of preeclampsia as 0.68, the optimal cut-off value was 122.78, sensitivity and specificity were 68.4% and 60.3%, respectively, with NLR ≥ 4.30, PLR ≤ 122.75. Both measures were predicting independent risk factors for preeclampsia, the combined predicted AUC was 0.854, the optimal cut-off value was 4.28, the sensitivity and specificity were 74.3% and 88.4%, respectively. Conclusion: NLR and PLR, as non-specific systematic validation indicators, have certain correlation with preeclampsia, which can be used to predict and evaluate preeclampsia, and are helpful to evaluate the progression and severity of preeclampsia, which have the value of risk warning and deserve clinical application.