Diagnostic value of uterine artery Doppler examination and serum COX-2 and vitamin D levels on severity of preeclampsia
Objective To investigate the diagnostic value of uterine artery Doppler examination,serum cyclooxygenase-2(COX-2)and vitamin D[25(OH)D]on the severity of preeclampsia(PE)in pregnant women.Methods The clinical data of 167 pregnant women with PE received by the Second Central Hospital of Baoding from December 2018 to December 2022 were retrospectively analyzed as the study group,and 100 normal pregnant women during the same period as the control group.Fasting venous blood was collected at 9～12 weeks of gestation to separate serum,and laboratory indicators such as coagulation function indexes and liver function indexes in serum and serum COX-2 and 25(OH)D levels were detected.At 20～24 weeks of pregnancy,color Doppler ultrasound was used to detect hemodynamic indexes.The two groups were compared with clinical data,serum COX-2,25(OH)D levels,resistance index(RI),and pulsation index(PI).Univariate analysis and Logistic regression analysis were used to determine the influencing factors of disease severity in PE pregnant women,and the receiver operating characteristic curve(ROC)was created to analyze the diagnostic value of uterine artery Doppler examination and serum COX-2 and 25(OH)D levels on the severity of PE in pregnant women.Results The activated partial prothrombin time(APTT),prothrombin time(PT),thrombin time(TT),platelet count(PLT),serum total protein(TP)level,and 25(OH)D level in the study group were significantly lower than those in the control group(P<0.05),and the mean platelet volume(MPV),serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatine kinase(CK),the levels of lactate dehydrogenase(LDH),serum creatinine(Scr),urea nitrogen(BUN),uric acid(UA),resistance index(RI),pulsatile index(PI)level,and COX-2 were significantly higher than those in the control group(P<0.05).The results of univariate and Logistic regression analysis showed that high levels of RI,PI and COX-2 and low levels of 25(OH)D were risk factors for PE disease severity(P<0.05);ROC curves showed that the AUC of serum COX-2,25(OH)D,uterine artery Doppler assay(RI +PI),RI + PI + COX-2,RI + PI +25(OH)D and RI + PI + COX-2 +25(OH)D were 0.735,0.696,0.786,0.881,0.825 and 0.931,respectively,with sensitivity of 61.11%,58.89%,72.22%,81.11%,73.33%and 84.44%,specificity of 79.22%,76.62%,79.22%,84.42%,79.22%and 89.61%,respectively.Conclusion The hemodynamic indexes RI、PI and serum COX-2 levels of PE pregnant women are significantly increased,and25(OH)D levels are significantly reduced,and uterine artery Doppler detection combined with serum COX-2 and vitamin D detection has certain clinical application value in predicting and diagnosing disease severity in PE pregnant women.
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