首页|血液炎性与肝功能指标对ICP诊断及分娩方式预测的效能分析

血液炎性与肝功能指标对ICP诊断及分娩方式预测的效能分析

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目的 观察妊娠肝内胆汁淤积症(ICP)患者实验室血液指标的变化,并分析血液炎性指标及肝功能指标在ICP诊断及分娩方式预测中的价值。方法 选取2021年1月至2022年12月该院确诊的初产ICP患者251例为ICP组,另选取200例健康孕妇作为对照组。并将ICP患者按严重程度与分娩方式进一步分为重度ICP组(n=47)与轻度ICP组(n=204)、顺产组(n=113)与剖宫产组(n=138)。组间各项参数比较采用Mann-Whitney U检验,相关性分析采用Spearman相关。采用受试者工作特征(ROC)曲线评估实验室指标诊断ICP与预测妊娠方式的效能。结果 ICP组中性粒细胞与淋巴细胞比值(NLR)[6。01(4。45,8。37)vs。3。36(4。12,3。51)]、天冬氨酸氨基转移酶(AST)[20。00(16。00,33。00)U/L vs。15。00(13。00,18。00)U/L]水平均明显高于对照组(P<0。05),且ICP重度组NLR明显高于轻度组[4。93(3。87,7。35)vs。4。14(3。12,5。17),P<0。05]。相关性分析显示,ICP患者NLR与AST水平(r=0。279,P<0。001)、ICP严重程度(r=0。139,P=0。028)均呈正相关。NLR联合 AST诊断ICP的ROC曲线下面积(AUC)为0。882(95%CI:0。851~0。913)。此外,顺产组胆碱酯酶(CHE)[6 020。00(5 499。50,6 703。50)U/L vs。5 341。50(4 651。75,6 259。25)U/L]和前白蛋白(PA)[199。00(177。71,225。20)mg/L vs。169。17(139。18,204。40)mg/L]水平明显高于剖宫产组(P<0。05),CHE 联合 PA 预测 ICP 患者顺产的 AUC 为 0。727(95%CI:0。664~0。789)。结论 NLR 和AST对ICP的诊断具有一定价值,CHE和PA对ICP患者分娩方式的预测有一定价值。
Efficacy analysis of blood inflammation and liver function indexes in ICP diagnosis and delivery mode prediction
Objective To observe the changes of laboratory blood indexes in patients with intrahepatic cholestasis of pregnancy(ICP),and analyze the value of blood inflammation indexes and liver function indexes in the diagnosis of ICP and the prediction of delivery mode.Methods A total of 251 patients diagnosed with ICP in this hospital from January 2021 to December 2022 were selected as the ICP group,and another 200 healthy pregnant women were selected as the control group.The patients with ICP were further divided into the severe ICP group(n=47)and the mild ICP group(n=204),the vaginal delivery group(n=113)and the cesarean section group(n=138)according to the severity of ICP and delivery mode.Mann-Whitney U test was used for comparison of parameters between groups,and Spearman method was used for correlation analy-sis.Receiver operating characteristic(ROC)curves were used to evaluate the efficacy of laboratory indicators in diagnosing ICP and predicting delivery mode.Results Neutrophil/lymphocyte ratio(NLR)[6.01(4.45,8.37)vs.3.36(4.12,3.51)]and aspartate transaminase(AST)level[20.00(16.00,33.00)U/L vs.15.00(13.00,18.00)U/L]in the ICP group were significantly higher than those in the control group(P<0.05),and NLR in the severe ICP group was significantly higher than that in the mild ICP group[4.93(3.87,7.35)vs.4.14(3.12,5.17),P<0.05].Correlation analysis showed that NLR was positively correlated with AST level(r=0.279,P<0.001)and ICP severity(r=0.139,P=0.028)in patients with ICP.The area under ROC curve(AUC)of NLR combined with AST for ICP diagnosis was 0.882(95%CI:0.851-0.913).In ad-dition,cholinesterase(CHE)[6 020.00(5 499.50,6 703.50)U/L vs.5 341.50(4 651.75,6 259.25)U/L]and prealbumin(PA)[199.00(177.71,225.20)mg/Lvs.169.17(139.18,204.40)mg/L]levels in the va-ginal delivery group were significantly higher than those in the cesarean section group(P<0.05),and the AUC of CHE combined with PA for predicting vaginal delivery in ICP patients was 0.727(95%CI:0.664-0.789).Conclusion NLR and AST have potential value in the diagnosis of ICP,and CHE and PA have poten-tial value in predicting delivery mode of ICP patients.

intrahepatic cholestasis of pregnancyneutrophil-lymphocyte ratioaspartate transaminasecholine esteraseprealbuminmode of delivery

张苑艳、张玲玲、孔琳、陈燕婷、黄启芸、唐丽春

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广西壮族自治区妇幼保健院产房,南宁 530002

广西壮族自治区妇幼保健院检验科,南宁 530002

妊娠肝内胆汁淤积症 中性粒细胞与淋巴细胞比值 天冬氨酸氨基转移酶 胆碱酯酶 前白蛋白 分娩方式

国家临床重点专科建设项目广西壮族自治区卫健委自筹课题

Z20210489

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(4)
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