孕28周血清维生素A、E水平对子痫前期孕妇妊娠结局预测价值

目的:分析血清维生素(V)A、VE水平预测子痫前期孕妇妊娠结局的价值。方法:以2017年6月-2018年11月本院常规孕前检查的427例女性(孕前组)及573例妊娠20周内产前检查孕妇(孕期组)为研究对象,孕期组定期产检后明确发生子痫前期53例。均检测血清VA、VE,孕期组同时行肝肾功能检测并统计妊娠结局。结果:与孕前组比较,孕期组妊娠20周时血清VA、VE水平及VE异常率未见差异(P>0.05),但VA缺乏率及异常率较高(P<0.05)。孕28周时,轻度、重度子痫前期孕妇血清VA、VE、血尿素氮(BUN)、血肌酐(SCR)水平均高于无子痫前期孕妇,且重度者高于轻度孕妇(P<0.05);血清VA、VE水平与BUN、SCR呈负相关(P<0.05);预测子痫前期孕妇不良妊娠结局的ROC曲线下面积分别为0.829、0.915,临界值分别为0.19mg/L、3.26mg/L,敏感度与特异度分别为61.9%、65.5%和92.3%、86.9%。结论:孕妇易出现VA缺乏,VA、VE对于预测子痫前期孕妇不良妊娠结局有一定价值。

The value of the serum Vitamin A and E levels of pregnant women with preeclampsia during 28 gestational weeks for predicting their pregnancy outcomes

Objective:To analyze the value of serum Vitamin(V)A and E levels of pregnant women with preeclampsia during 28 gestational weeks for predicting their pregnancy outcomes.Methods:427 women before pregnancy(in group A)and 573 pregnant women within gestational 20 weeks(in group B,included 53 women with preeclampsia)were selected as the research objects from June 2017 to November 2018.Serum VA and VE levels and liver and kidney function of all included women were detected,and their pregnancy outcomes were statistically analyzed.Results:The average serum VA and VE levels of women during 20 gestational weeks in group B had no significant different to those of women in group A(P>0.05),but the abnormal rate of VE level of women in group B was significant lower,the rates of VA deficiency and abnormal were significant higher(P<0.05).In group B,the incidence of preeclampsia was 9.3%.In 28 gestational weeks of women in group B,the serum levels of VA and VE,the values of blood urea nitrogen(BUN)and serum creatinine(SCR)of women with mild and severe preeclampsia were significant higher than those of women without preeclampsia,and those of women with severe preeclampsia were significant higher than those of women with mild preeclampsia(P<0.05).Serum levels of VA and VE of women were negatively correlated with their values of BUN and SCR(P<0.05).The area under the ROC curve predicted by serum VA and VE levels was 0.829 and 0.915,their sensitivity were 61.9%and 65.5%,and their specificity were 92.3%and 86.9%.Conclusion:Pregnant women prone to have VA deficiency.And abnormal VA and VE levels may predicte adverse pregnancy outcomes of pregnant women with preeclampsia,so the monitoring and supplementation of VA and VE should be emphasized during pregnancy.