摘要
目的:探讨血清超敏C反应蛋白(hs-CRP)、D二聚体(D-D)、同型半胱氨酸(Hcy)水平对妊娠期高血压疾病(HDP)患者不良妊娠结局的预测价值。方法:回顾性选取某院2022年6月—2024年6月收治的248例HDP患者为研究对象,根据不良妊娠结局发生情况分为不良组和正常组。比较2组一般资料及血清hs-CRP、D-D、Hcy水平,采用多因素Logistic回归方程分析HDP患者发生不良妊娠结局的影响因素;绘制ROC曲线,分析血清hs-CRP、D-D、Hcy水平对HDP患者不良妊娠结局的预测价值。结果:248例HDP患者发生不良妊娠结局38例(15.32%),其中低出生体重儿23例、心血管畸形7例、终止妊娠6例、死胎2例。不良组年龄、收缩压、舒张压及吸烟史、饮酒史比例高于正常组,血清hs-CRP、D-D、Hcy水平高于正常组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,有吸烟史(OR=13.956)、饮酒史(OR=7.649)及年龄(OR=3.667)、收缩压(OR=4.015)、舒张压(OR=5.982)、hs-CRP(OR=13.561)、D-D(OR=19.342)、Hcy(OR=17.258)水平高是HDP患者发生不良妊娠结局的危险因素(P<0.05)。ROC分析显示,血清hs-CRP、D-D、Hcy水平预测HDP患者发生不良妊娠结局的AUC分别为0.869、0.876、0.854,三者联合检测的AUC为0.926,敏感度为0.990,特异度为0.894。结论:有吸烟史、饮酒史及年龄、收缩压、舒张压、hs-CRP、D-D、Hcy水平高是HDP患者发生不良妊娠结局的危险因素,血清hs-CRP、D-D、Hcy水平均对HDP患者发生不良妊娠结局有一定的预测价值,且联合检测预测价值较高。
Objective:To investigate the predictive value of serum high-sensitivity C-reactive protein(hs-CRP),D-dimer(D-D),and homocysteine(Hcy)levels for adverse pregnancy outcomes in patients with hypertensive disorders of pregnancy(HDP).Methods:A total of 248 HDP patients admitted to Zhengzhou Third People's Hospital from June 2022 to June 2024 were selected as the study subjects.Based on the occurrence of adverse pregnancy outcomes,they were divided into an adverse outcome group and a favorable outcome group.General data and serum levels of hs-CRP,D-D,and Hcy were compared between the two groups.Multivariate logistic regression analysis was used to identify influencing factors for adverse pregnancy outcomes in HDP patients.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of serum hs-CRP,D-D,and Hcy levels for adverse pregnancy outcomes in HDP patients.Results:Among the 248 HDP patients,38(15.32%)experienced adverse pregnancy outcomes,including 23 cases of low birth weight,7 cases of cardiovascular malformations,6 cases of pregnancy termination,and 2 cases of stillbirth.The adverse outcome group had higher proportions of advanced age,high systolic blood pressure,high diastolic blood pressure,and smoking and drinking history than those of the favorable outcome group.Serum levels of hs-CRP,D-D,and Hcy were also higher in the adverse outcome group,with statistically significant differences(P<0.05).Multivariate logistic regression analysis showed that smoking history,drinking history,advanced age,high systolic blood pressure,high diastolic blood pressure,and elevated levels of hs-CRP,D-D,and Hcy were risk factors for adverse pregnancy outcomes in HDP patients(P<0.05).ROC analysis revealed that the AUC values for predicting adverse pregnancy outcomes using serum hs-CRP,D-D,and Hcy levels were 0.869,0.876,and 0.854,respectively.The combined detection of the three markers yielded an AUC of 0.926,with a sensitivity of 0.990 and a specificity of 0.894.Conclusion:Smoking history,drinking history,advanced age,high systolic blood pressure,high diastolic blood pressure,and elevated levels of hs-CRP,D-D,and Hcy are risk factors for adverse pregnancy outcomes in HDP patients.Serum hs-CRP,D-D,and Hcy levels have certain predictive value for adverse pregnancy outcomes in HDP patients,with higher predictive value achieved through combined detection.
作者
候甜甜
芦瑞丹
何晓莉
HOU Tiantian;LU Ruidan;HE Xiaoli(Clinical Laboratory,Zhengzhou Third People's Hospital,Zhougzhou,Henan 450053,China)
出处
《淮海医药》
2025年第2期122-125,共4页
Journal of Huaihai Medicine
基金
河南省科技攻关计划项目(LHGJ20220821)。
