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子痫前期的特征是在妊娠20周后,原血压正常的孕妇出现蛋白尿或多脏器功能障碍,是孕妇围生期发病、死亡的主要原因,全球范围发病率约为4.6%[1]。子痫前期的发病原因尚未明确,目前普遍认为与炎症及引发的机体高凝状态有关。研究[2-3]表明可能是炎症细胞的超活化、中性粒细胞和淋巴细胞免疫应答,释放炎性细胞因子以及产生自身抗体导致内皮功能障碍,引起血管收缩和终末器官缺血,病人出现血栓和高凝状态,导致子痫前期的发生发展。血细胞分析参数中的中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、红细胞分布宽度变异系数(RDW-CV)、血小板分布宽度(PDW)、平均血小板体积(MPV)是全身炎症反应标志物,同时血小板参数,包括PDW、MPV是反映凝血功能的指标。本文旨在评估NLR、PLR、RDW-CV、PDW和MPV变化与子痫前期之间的关系以及MPV在诊断子痫前期中价值。
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对照组年龄、N、L、PDW、MPV水平与子痫前期组比较差异均有统计学意义(P < 0.05~P < 0.01)(见表 1)。
分组 n 年龄/岁 N/(×109/L) L/(×109/L) P/(×109/L) NLR PLR RDW-CV/% PDW/% MPV/fL 对照组 54 26.7±4.3 8.1±2.9 1.6±0.4 203±62 5.5±3.0 134.1±53.2 15.2±1.8 15.8±0.9 9.6±0.9 子痫前期组 91 29.1±3.0 1.7±0.5 6.7±2.0 201±58 6.0±2.7 132.1±53.5 15.3±2.7 14.9±2.5 10.8±1.3 t — 29.05 20.7 18.5 0.2 1.04 0.22 0.24 2.55 5.99 P — < 0.01 < 0.01 < 0.01 >0.05 >0.05 >0.05 >0.05 < 0.05 < 0.01 表 1 对照组与子痫前期组NLR、PLR、RDW-CV、PDW、MPV水平比较(x±s)
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3组之间年龄、N、PDW、MPV水平差异具有统计学意义(P < 0.05~P < 0.01)。对照组与轻度子痫前期组年龄、MPV水平差异具有统计学意义(P < 0.05~P < 0.01),对照组与重度子痫前期组之间年龄、N、PDW、MPV水差异具有统计学意义(P < 0.05~P < 0.01),轻度子痫前期组与重度子痫前期组之间N差异具有统计学意义(P < 0.01)(见表 2)。
分组 n 年龄/岁 N/(×109/L) L/(×109/L) P/(×109/L) NLR PLR RDW-CV/% PDW/% MPV/fL 对照组 54 26.7±4.3 8.1±2.9 1.6±0.4 203±62 5.5±3.0 134.1±53.2 15.2±1.8 15.8±0.9 9.6±0.9 轻度子痫前期组 34 29.4±7.3* 7.7±2.2 1.6±0.5 212±52 5.5±2.6 148.8±59.3 15.0±1.7 15.1±2.9 10.8±1.5** 重度子痫前期组 57 29.6±6.1* 9.9±3.1**## 1.7±0.5 195±60 6.3±2.7 122.4±47.6 15.5±3.1 14.7±2.3* 10.9±1.1** F — 4.00 8.41 0.80 0.90 1.42 2.70 0.51 3.92 20.82 P — < 0.05 < 0.01 >0.05 >0.05 >0.05 >0.05 >0.05 < 0.05 < 0.01 MS组内 — 33.96 8.054 0.216 3 482.845 7.805 2 767.109 5.671 4.343 1.302 q检验:与对照组比较*P < 0.05,**P < 0.01;与轻度子痫前期组比较##P < 0.01 表 2 3组病人NLR、PLR、RDW-CV、PDW、MPV水平比较
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MPV诊断子痫前期的曲线下面积为0.791(0.717~0.866),MPV=10.35 fL时诊断子痫前期敏感度为68.5%,特异度为87.0%。
血细胞分析参数与子痫前期的相关性分析
Correlation analysis between blood cell parameters and preeclampsia
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摘要:
目的分析探讨中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、红细胞分布宽度变异系数(RDW-CV)、平均血小板体积(MPV)在正常妊娠与子痫前期间的相关性,及MPV在子痫前期中的诊断价值。 方法选取轻度子痫前期34例、重度子痫前期57例及同期正常妊娠孕妇54名(对照组),空腹抽取静脉血,进行全血细胞分析,比较NLR、PLR、RDW-CV、血小板分布宽度(PDW)、MPV。 结果对照组与轻度子痫前期组及重度子痫前期组的MPV水平差异均具有统计学意义(P < 0.05)。对照组年龄、中性粒细胞计数(N)、淋巴细胞计数、PDW、MPV水平与子痫前期组相比差异具有统计学意义(P < 0.05~P < 0.01)。轻度子痫前期组与重度子痫前期之间N差异具有统计学意义(P < 0.05),MPV水平无差异。MPV=10.35时诊断子痫前期的敏感度为68.5%,特异度为87.0%。 结论MPV与子痫前期的发生密切相关,是诊断子痫前期的有效标志物。 -
关键词:
- 子痫前期 /
- 中性粒细胞与淋巴细胞比值 /
- 血小板与淋巴细胞比值 /
- 红细胞分布宽度变异系数 /
- 血小板分布宽度 /
- 平均血小板体积
Abstract:ObjectiveTo investigate the correlation of neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), coefficient of variation of erythrocyte distribution width(RDW-CV) and mean platelet volume(MPV) between normal pregnancy and preeclampsia, and diagnostic value of MPV in preeclampsia. MethodsThe whole blood cell in 34 pregnant women with mild preeclampsia, 57 pregnant women with severe preeclampsia and 54 normal pregnant women(control group) were analyzed.The NLR, PLR, RDW-CV, distribution width of platelet(PDW) and MPV among all patients were analyzed. ResultsThe differences of the levels of MPV among control group, mild preeclampsia group and severe preeclampsia group were statistically significant(P < 0.05).The differences of the age, neutrophil count, lymphocyte count, PDW and MPV between the control group and preeclampsia group were statistically significant(P < 0.05 to P < 0.01).The difference of neutrophil count between mild preeclampsia group and severe preeclampsia group was statistically significant(P < 0.05).The sensitivity and specificity of MPV=10.35 was 68.5% and 87.0%, respectively. ConclusionsMPV is closely correlated with to the occurrence of preeclampsia, and an effective marker for diagnosis of preeclampsia. -
表 1 对照组与子痫前期组NLR、PLR、RDW-CV、PDW、MPV水平比较(x±s)
分组 n 年龄/岁 N/(×109/L) L/(×109/L) P/(×109/L) NLR PLR RDW-CV/% PDW/% MPV/fL 对照组 54 26.7±4.3 8.1±2.9 1.6±0.4 203±62 5.5±3.0 134.1±53.2 15.2±1.8 15.8±0.9 9.6±0.9 子痫前期组 91 29.1±3.0 1.7±0.5 6.7±2.0 201±58 6.0±2.7 132.1±53.5 15.3±2.7 14.9±2.5 10.8±1.3 t — 29.05 20.7 18.5 0.2 1.04 0.22 0.24 2.55 5.99 P — < 0.01 < 0.01 < 0.01 >0.05 >0.05 >0.05 >0.05 < 0.05 < 0.01 表 2 3组病人NLR、PLR、RDW-CV、PDW、MPV水平比较
分组 n 年龄/岁 N/(×109/L) L/(×109/L) P/(×109/L) NLR PLR RDW-CV/% PDW/% MPV/fL 对照组 54 26.7±4.3 8.1±2.9 1.6±0.4 203±62 5.5±3.0 134.1±53.2 15.2±1.8 15.8±0.9 9.6±0.9 轻度子痫前期组 34 29.4±7.3* 7.7±2.2 1.6±0.5 212±52 5.5±2.6 148.8±59.3 15.0±1.7 15.1±2.9 10.8±1.5** 重度子痫前期组 57 29.6±6.1* 9.9±3.1**## 1.7±0.5 195±60 6.3±2.7 122.4±47.6 15.5±3.1 14.7±2.3* 10.9±1.1** F — 4.00 8.41 0.80 0.90 1.42 2.70 0.51 3.92 20.82 P — < 0.05 < 0.01 >0.05 >0.05 >0.05 >0.05 >0.05 < 0.05 < 0.01 MS组内 — 33.96 8.054 0.216 3 482.845 7.805 2 767.109 5.671 4.343 1.302 q检验:与对照组比较*P < 0.05,**P < 0.01;与轻度子痫前期组比较##P < 0.01 -
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