妊娠早期血红蛋白和血清铁蛋白预测子痫前期的价值分析OA
Analysis on the Value of Hemoglobin and Serum Ferritin in Predicting Pre-eclampsia during Early Pregnancy
目的:探讨妊娠早期血红蛋白、血清铁蛋白水平对子痫前期的预测价值,为临床早期筛查提供依据.方法:采用回顾性病例对照研究,选择2022 年5 月1 日至2024 年2 月28 日在银川市妇幼保健院产检并分娩的孕妇 321 例,根据是否确诊子痫前期分为观察组(164 例)和对照组(157例),观察组进一步按照疾病分型分为非重度子痫前期组(80 例)和重度子痫前期组(84 例).收集妊娠早期(10～13+6 周)血红蛋白、血清铁蛋白及血清铁检测数据并进行比较,采用单因素Logistic回归分析筛选子痫前期相关危险因素,并通过受试者工作特征(ROC)曲线和曲线下面积(AUC)评估各指标及联合检测的预测效能.结果:观察组血红蛋白(129.85±12.92 g/L vs.125.62±10.43 g/L)和血清铁蛋白(44.27 μg/L vs.32.30 μg/L)水平均显著高于对照组(P<0.05).但重度子痫前期组与非重度子痫前期组比较,血红蛋白、血清铁蛋白水平差异无统计学意义(P>0.05).单因素Logistic回归分析显示,血红蛋白(OR 1.037,95％CI 1.014～1.061)和血清铁蛋白(OR 1.013,95％CI 1.005～1.022)是子痫前期的影响因素(P<0.05).ROC曲线分析表明,血清铁蛋白预测子痫前期的截断值为 30.25 μg/L(敏感度 78.7％,特异度 47.8％,AUC 0.624);血红蛋白截断值为127.63 g/L(敏感度 62.2％,特异度 56.7％,AUC 0.624);联合检测特异度提高至 70.7％(AUC 0.642).结论:妊娠早期血红蛋白和血清铁蛋白水平升高与子痫前期发生显著相关,可作为其独立预测指标,联合检测可提高预测特异度,具有潜在临床应用价值.
Objective:To explore the predictive value of hemoglobin and serum ferritin levels in early pregnan-cy for preeclampsia,so as to provide a basis for early clinical screening.Methods:A retrospective case-control study was conducted.A total of 321 pregnant women who received prenatal examination and delivered in Yin-chuan Maternal and Child Health Hospital from May 1,2022 to February 28,2024 were selected.They were divided into the observation group(164 cases)and the control group(157 cases)according to whether preeclampsia was diagnosed.The observation group was further divided into the non-severe preeclampsia subgroup(80 cases)and the severe preeclampsia subgroup(84 cases)according to disease classification.The detection data of hemoglo-bin,serum ferritin and serum iron in early pregnancy(10-13+6 weeks)were collected and compared.Univariate Logistic regression analysis was used to screen the risk factors related to preeclampsia,and the receiver operat-ing characteristic(ROC)curve and the area under the curve(AUC)were used to evaluate the predictive efficacy of each index and combined detection.Results:The levels of hemoglobin(129.85±12.92 g/L vs.125.62±10.43 g/L)and serum ferritin(44.27 μg/L vs.32.30 μg/L)in the observation group were significantly higher than those in the control group(P<0.05).However,there was no statistically significant difference in hemoglobin and serum ferritin levels between the severe preeclampsia subgroup and the non-severe preeclampsia subgroup(P>0.05).Univariate Logistic regression analysis showed that hemoglobin(OR 1.037,95％CI 1.014-1.061)and ser-um ferritin(OR 1.013,95％CI 1.005-1.022)were influencing factors for preeclampsia(P<0.05).ROC curve a-nalysis showed that the cut-off value of serum ferritin for predicting preeclampsia was 30.25 μg/L(sensitivity 78.7％,specificity 47.8％,AUC 0.624),the cut-off value of hemoglobin was 127.63 g/L(sensitivity 62.2％,speci-ficity56.7％,AUC0.624),the specificity of combined detection was increased to70.7％(AUC0.642).Conclu-sions:The increased levels of hemoglobin and serum ferritin in early pregnancy are significantly associated with the occurrence of preeclampsia,which can be used as independent predictive indicators.Combined detection can improve the predictive specificity and has potential clinical application value.
雍敏婕;别荔;杨丽娜
银川市妇幼保健院产科,宁夏 银川 750000银川市妇幼保健院产科,宁夏 银川 750000银川市妇幼保健院产科,宁夏 银川 750000
医药卫生
子痫前期血红蛋白血清铁蛋白预测妊娠早期
PreeclampsiaHemoglobinSerum ferritinPredictingEarly Pregnancy
《实用妇产科杂志》 2026 (1)
82-86,5
宁夏回族自治区卫生健康委科研课题(编号:2022-NWKY-072)
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