评估作为子痫前期预测指标的血液炎症标记物

Ş. Genç, Huseyin Erdal
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摘要

背景:子痫前期占妊娠的 2-8%,其特点是新发高血压、蛋白尿和水肿,源于胎盘功能障碍和随后的炎症级联激活。本研究旨在测试血液学指标对子痫前期的预测能力。因此,如果能更早更准确地预测子痫前期的诊断,就有可能保护母亲和胎儿的生命,同时降低并发症的发生率。方法:这项回顾性研究包括两组:子痫前期患者和无其他疾病的匹配对照组,两组患者均在同一孕周分娩。两组患者的主要区别在于先兆子痫的诊断。分析比较了血液学参数和炎症指数。结果:观察发现,组间中性粒细胞-淋巴细胞比值(dNLR)、全身免疫炎症指数(SIRI)和泛免疫炎症值(PIV)之间存在统计学意义。dNLR 和 PIV 对子痫前期有预测作用(P < 0.05)。然而,它们的预测性能较弱(曲线下(AUC)< 0.5)。结合这些指数的综合指数(CoI)的AUC更高,达到0.62,表明其预测能力有限。结论 :这些研究结果证实了子痫前期与炎症增加之间的相关性。炎症标志物如 dNLR、SIRI 和 PIV 具有统计学意义,但由于其敏感性和特异性较低,在临床上并不实用。研究结果突出表明,有必要探索一种结合这些标记物的 CoI,以提高预测准确性和临床实用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluating Hematological Inflammatory Markers as Predictors of Preeclampsia
Background : Preeclampsia, affecting 2–8% of pregnancies, is characterized by new-onset hypertension, proteinuria, and edema, stemming from placental dysfunction and subsequent inflammatory cascade activation. This study aimed to test the predictive ability of hematological indices in predicting preeclampsia. Therefore, predicting the diagnosis of preeclampsia earlier with higher accuracy could potentially preserve the lives of both the mother and the fetus, while also reducing the rates of complications. Methods : This retrospective study included two groups: patients with preeclampsia and a matched control group without additional medical conditions, both having undergone childbirth in the same gestational week. The primary difference between the groups was the preeclampsia diagnosis. Hematological parameters and inflammatory indices were compared for analysis. Results : Statistical significance was observed between derived neutrophil-lymphocyte ratio (dNLR), systemic immune-inflammation index (SIRI) and pan-immune inflammation value (PIV) between groups. The dNLR and PIV showed predictive relevance for preeclampsia ( p < 0.05). However, their predictive performance was weak (under the curve (AUC) < 0.5). A composite index (CoI) combining these indices achieved a higher AUC of 0.62, indicating limited better predictive performance capability. Conclusions : These findings affirm the correlation between preeclampsia and increased inflammation. Inflammatory markers like the dNLR, SIRI, and PIV showed statistical significance but were not practically useful in clinical settings due to their low sensitivity and specificity. The results highlight the necessity of exploring a CoI, which combines these markers, to enhance predictive accuracy and clinical utility.
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