目的 观察重度子痫前期患者不良妊娠结局的影响因素,基于影响因素构建风险预测模型.方法 回顾性选取2020年4月—2022年10月乌鲁木齐市第一人民医院分院产科收治的108例重度子痫前期患者资料,依据是否发生不良妊娠结局分为发生组(n=34)与未发生组(n=74),分析不良妊娠结局的影响因素,绘制受试者工作特征曲线并构建列线图预测模型.结果 发生组血清维生素A(vitamin A,VA)、维生素E(vitamin E,VE)、类胰岛素1号增长因子(serum insulin like growth factor-1,IGF-1)均低于未发生组,可溶性fms样酪氨酸激酶-1(soluble fms like tyrosine kinase-1,sFlt-1)水平高于未发生组,差异有统计学意义(P均<0.05).血清VA、VE、IGF-1、sFlt-1是重度子痫前期患者不良妊娠结局的独立危险因素(OR=6.915、8.854,9.760、8.323,P均<0.001).血清VA、VE、IGF-1、sFlt-1预测不良妊娠结局风险的曲线下面积均>0.80,列线图风险预测模型拟合反应、辨别度均理想,整体风险预测价值较好.结论 血清VA、VE、IGF-1、sFlt-1水平异常是重度子痫前期患者不良妊娠结局的危险因素,列线图风险预测模型可以较好预测重度子痫前期患者不良妊娠结局风险患者群体.
Analysis of Factors Influencing Adverse Pregnancy Outcomes in Patients with Severe Preeclampsia and Construction of Risk Prediction Models
Objective To observe the influencing factors of adverse pregnancy outcomes in patients with severe pre-eclampsia,and build a risk prediction model based on the influencing factors.Methods The data of 108 patients with severe preeclampsia admitted to the obstetrics Department of Urumqi First People's Hospital from April 2020 to Octo-ber 2022 were retrospectively selected.According to whether adverse pregnancy outcome occurred,they were divided into occurrence group(n=34)and non-occurrence group(n=74),and the influencing factors of adverse pregnancy out-come were analyzed.The working characteristic curve of the subject is drawn and the prediction model of the nomo-gram is constructed.Results Serum vitamin A(VA),vitamin E(VE),and serum insulin like growth factor-1(IGF-1)in the occurrence group were lower than those in the non-occurrence group,soluble fms like tyrosine kinase-1(sFlt-1)level was higher than in the non-occurrence group,and the intraoperative blood loss was less,the differences were statistically significant(all P<0.05).Serum VA,VE,IGF-1 and sFlt-1 were independent risk factors for adverse preg-nancy outcomes in patients with severe preeclampsia(OR=6.915,8.854,9.760,8.323,all P<0.001).The area under the curve of serum VA,VE,IGF-1 and sFlt-1 to predict the risk of adverse pregnancy outcomes was more than 0.80,and the fitting response and discrimination of the risk prediction model in the nomogram were ideal,and the overall risk prediction value was good.Conclusion Abnormal serum levels of VA,VE,IGF-1 and sFlt-1 are risk factors for adverse pregnancy outcomes in patients with severe preeclampsia,and the risk prediction model of columniogram can better predict the risk group of adverse pregnancy outcomes in patients with severe preeclampsia
Severe preeclampsiaPregnancy outcomeVitaminsInsulin growth factorTyrosine kinasePrediction
万方数据
维普
