维生素C和维生素E水平与子痫前期的相关性

目的采用受试者工作曲线(ROC曲线)分析孕妇体内维生素C、E水平预测子痫前期发生的相关性。方法对2016年1月-2017年1月于宁波市奉化区妇幼保健院早期产检并分娩的412例妊娠女性进行分析,根据妊娠20周后是否发生子痫,将其分为子痫前期组(PE组,68例)及对照组(344例),采用高效液相色谱法及酶免疫联法对2组孕妇孕前期及孕中期的血清维生素C、维生素E、妊娠相关血浆蛋白A(PAPP-A)及胎盘生长因子(PLGF)进行检测并比较,应用ROC曲线分析维生素C、E预测子痫前期的诊断价值。结果 2组孕妇孕早期的PAPP-A均明显高于孕中期,PLGF低于孕中期(均P<0.05),且PE组孕妇的PAPP-A明显高于对照组(t=5.333、6.225,均P<0.05),PLGF低于对照组(t=4.398、7.771,均P<0.05);2组孕妇孕中期的维生素C、E水平均明显低于孕早期,且PE组明显低于对照组(均P<0.05);孕中期不同指标预测子痫前期的ROC曲线示维生素E的曲线下面积为0.929,明显高于维生素C、PLGF及PAPP-A(AUC=0.836、0.813、0.756,均P<0.05),此时维生素E的最佳截点为≤15.003,敏感度为97.0%,特异性为80.6%。结论孕中期孕妇体内的维生素C、E水平明显下降,其可有效预测子痫前期的发生,具有较高的诊断效能,而维生素E的诊断效能更高。

Correlation between vitamin C and vitamin E levels and preeclampsia

Objective To analyze the correlation of vitamin C and E levels in pregnant women with pre-eclampsia by using receiver working curve (ROC curve). Methods A total of 412 pregnant women who were initially examined and delivered in our hospital from January 2016 to January 2017 were analyzed. According to whether or not eclampsia occurred after 20 weeks of gestation, they were divided into preeclampsia group (PE group, 68 cases) and the control group (344 cases). High performance liquid chromatography and enzyme immunoassay for serum vitamin C, vitamin E, pregnancy-related plasma protein A (PAPP-A) in the two groups of pregnant women and pre-pregnancy placental growth factor (PLGF) were tested and compared, and the diagnostic value of pre-eclampsia was predicted by ROC curve analysis of vitamin C and E. Results PAPP-A in the early pregnancy was significantly higher in the two groups than in the second trimester. PLGF was lower than the second trimester (P<0.05), and the PAPP-A in the PE group was significantly higher than that in the control group (t=5.333, 6.225, all P<0.05), PLGF was lower than the control group (t=4.398, 7.771, all P<0.05). The vitamin C and E levels in the second trimester of pregnancy were significantly lower in the two groups than in the first trimester, and the PE group was significantly lower than the control group (all P<0.05); different indicators in the second trimester predict the preeclampsia ROC curve showing that the area under the curve of vitamin E is 0.929 which is significantly higher than vitamin C, PLGF and PAPP-A (AUC=0.836, 0.813, 0.756, all P<0.05), the optimal cut-off point of vitamin E at this time is ≤15.003, the sensitivity is 97.0%, and the specificity is 80.6%. Conclusion The levels of vitamin C and E in pregnant women are significantly decreased in the second trimester, which can effectively predict the occurrence of preeclampsia, and has a higher diagnostic efficiency, while the diagnostic efficacy of vitamin E is higher.