Peralta Pedrero María Luisa, Basavilvazo Rodríguez Ma Antonia, Cruz Avelar Agles, Sánchez Ambríz Silvia, Guzmán Ibarra María de los Angeles, Martínez García María del Carmen
Unidad de Medicina Familiar núm. 93, IMSS.
Ginecol Obstet Mex. 2004 Feb;72:57-62.
To determine the clinical significance and optimal cutting points of laboratory tests more frequently used in patients with pre-eclampsia of recent diagnosis.
We made an analytic cross-sectional study for evaluation of diagnostic test. Non probabilistic sampling. Sample size 400 patients. We used the American College of Obstetricians and Gynecologists criteria as gold standard. Laboratory personnel was blinded to the clinical classification of the patients.
We studied 192 patients without pre-eclampsia, 63 with mild and 153 with severe pre-eclampsia. Hematocrits, prothrombin time, partial thromboplastin time, aspartate aminotransferase, alanine aminotransferase and bilirubins did not show significative differences among groups. Platelets counting showed low sensitivity. Lactic dehydrogenase showed 71% sensitivity (65-85 CI95%), specificity 74% (68-80 CI95%) positive likelihood ratio 2.7 and negative 0.4. Uric acid showed sensitivity of 75% (69-81 CI95%) specificity 79% (73-85 CI95%) positive likelihood ratio of 3.5 and negative of 0.3. Seric creatinine with sensitivity of 81% (76-86 CI95%) specificity of 60% (53-67 CI95%) positive likelihood ratio of 2 and negative of 0.3.
Seric uric acid, seric creatinine and lactic dehydrogenase are useful for diagnosis and severity classification of pre-eclampsia. Platelets counting is not useful for diagnosis but is useful for severity classification. In patients with thrombocytopenia prothrombin time is useful for severity classification.
确定近期诊断的子痫前期患者中更常用实验室检查的临床意义及最佳切点。
我们进行了一项分析性横断面研究以评估诊断试验。采用非概率抽样。样本量为400例患者。我们将美国妇产科医师学会的标准作为金标准。实验室工作人员对患者的临床分类不知情。
我们研究了192例无子痫前期的患者、63例轻度子痫前期患者和153例重度子痫前期患者。血细胞比容、凝血酶原时间、活化部分凝血活酶时间、天冬氨酸转氨酶、丙氨酸转氨酶和胆红素在各组之间未显示出显著差异。血小板计数显示敏感性较低。乳酸脱氢酶显示敏感性为71%（95%置信区间65 - 85），特异性为74%（95%置信区间68 - 80），阳性似然比为2.7，阴性似然比为0.4。尿酸显示敏感性为75%（95%置信区间69 - 81），特异性为79%（95%置信区间73 - 85），阳性似然比为3.5，阴性似然比为0.3。血清肌酐敏感性为81%（95%置信区间76 - 86），特异性为60%（95%置信区间53 - 67），阳性似然比为2，阴性似然比为0.3。
血清尿酸、血清肌酐和乳酸脱氢酶对子痫前期的诊断和严重程度分类有用。血小板计数对诊断无用，但对严重程度分类有用。在血小板减少的患者中，凝血酶原时间对严重程度分类有用。
