孕妇血清维生素A、维生素E、25-羟基维生素D与 子痫前期的相关性研究

目的 探讨孕妇血清维生素A、维生素E、25-羟基维生素D水平与子痫前期的相关性。方法 选择2016年3月~2017年10月在我院产检的单胎孕妇为研究对象，其中子痫前期组72例，健康对照组30例。分析血清维生素A、维生素E、25-羟基维生素D水平与子痫前期的相关性及其诊断价值。结果 在孕10~14周时，两组孕妇孕血清维生素A、维生素E 、25-羟基维生素D水平比较，差异无统计学意义（P＞0.05）；孕24~28周时，子痫前期组血清维生素A、维生素E 、25-羟基维生素D水平低于对照组水平（P＜0.05）；多因素Logistic回归分析结果显示，孕24~28周血清维生素A、维生素E、25-羟基维生素D水平与子痫前期发病具有显著的相关性；回归模型显示，血清维生素A诊断子痫前期的AUC为0.976，95%CI为0.931~1.000，当界值为0.46时，预测子痫前期发病的灵敏度为95.70%，特异度为72.50%；维生素E诊断子痫前期的AUC为0.820，95%CI为0.725~0.914，当界值为0.28时，预测子痫前期发病的灵敏度为76.70%，特异度为77.80%；25-羟基维生素D诊断子痫前期的AUC为0.789，95%CI为0.681~0.898，当界值为0.33时，预测子痫前期发病的灵敏度为73.30%，特异度为81.90%；血清维生素A+维生素E+25-羟基维生素D诊断子痫前期的AUC为0.988，95%CI为0.966~1.000。当界值为0.55时，预测子痫前期发病的灵敏度为96.70%，特异度为95.80%。结论 在孕10~14周时，血清维生素A、维生素E、25-羟基维生素D水平下降与子痫前期发病无关；在孕24~28周时，血清维生素A、维生素E、25-羟基维生素D水平下降与子痫前期发病显著相关，孕晚期血清维生素A、维生素E、25-羟基维生素D可作为子痫前期的关键指标。

Correlation between Serum Vitamin A,Vitamin E,25-hydroxyvitamin D and Pre-eclampsia in Pregnant Women

Abstract:Objective To investigate the correlation between serum vitamin A, vitamin E and 25-hydroxyvitamin D levels in pregnant women and pre-eclampsia. Methods The single-fetal pregnant women who were examined in our hospital from March 2016 to October 2017 were selected as the study subjects, including 72 cases in the preeclampsia group and 30 healthy controls. The correlation between serum vitamin A, vitamin E,25-hydroxyvitamin D levels and pre-eclampsia and its diagnostic value were analyzed. Results At 10 to 14 weeks of pregnancy, there was no significant difference in serum vitamin A, vitamin E and 25-hydroxyvitamin D levels between the two groups (P>0.05). At 24 to 28 weeks of gestation, the pre-eclampsia group Serum levels of vitamin A, vitamin E and 25-hydroxyvitamin D were lower than those of the control group (P<0.05).Multivariate logistic regression analysis showed that serum vitamin A, vitamin E, and 25-hydroxyvitamin D levels were significantly correlated with pre-eclampsia at 24 to 28 weeks of pregnancy. Regression models showed that serum vitamin A was diagnosed with pre-eclampsia AUC. 0.976, 95% CI was 0.931~1.000, when the cutoff value was 0.46, the sensitivity of predicting pre-eclampsia was 95.70%, the specificity was 72.50%; the AUC of vitamin E diagnosis pre-eclampsia was 0.820, 95% CI was 0.725~0.914, when the cut-off value is 0.28, the sensitivity of predicting pre-eclampsia is 76.70%, the specificity is 77.80%; the AUC of 25-hydroxyvitamin D is pre-eclampsia is 0.789, 95% CI is 0.681~0.898, When the cut-off value is 0.33, the sensitivity of predicting pre-eclampsia is 73.30%, and the specificity is 81.90%. The serum A-vitamin A+vitamin E+25-hydroxyvitamin D is pre-eclampsia with an AUC of 0.988 and 95% CI of 0.966~ 1.000. When the cutoff value is 0.55, the sensitivity of predicting pre-eclampsia is 96.70%, and the specificity is 95.80%. Conclusion At the age of 10~14 weeks, the serum levels of vitamin A, vitamin E and 25-hydroxyvitamin D are not related to the pre-eclampsia. At the age of 24~28 weeks, serum vitamin A, vitamin E and 25-hydroxyvitamin D The level of decline is significantly associated with pre-eclampsia, and serum vitamin A, vitamin E, and 25-hydroxyvitamin D can be used as key indicators of pre-eclampsia in the third trimester.