Hu Guomin, Guan Rui, Li Li
From the Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University (Central Hospital of Minhang District), Shanghai, China (GH, RG).
The Department of Obstetrics and Gynecology, First Affiliated Hospital, Second Military Medical University, Shanghai, China (RG, LL).
Am J Med Sci. 2016 Feb;351(2):140-6. doi: 10.1016/j.amjms.2015.11.008.
We investigated the correlations of nucleated red blood cell (NRBC) counts with hypertensive disorders in pregnancy (HDP) and fetal umbilical blood flow velocity.
We recruited 282 patients with HDP as experimental group including 107 with mild pre-eclampsia (A1 group), 100 with severe pre-eclampsia (A2 group) and 75 with eclampsia (A3 group), and 215 normal pregnant women as control group. Maternal peripheral venous blood was collected and isolated cells were stained with Wright-Giemsa. We estimated NRBC counts according to laboratory routine and Doppler ultrasound examinations were employed to measure the systolic/diastolic (S/D) ratios of fetal ductus venosus, umbilical artery and middle cerebral artery.
The NRBC counts in A1, A2 and A3 groups were higher than control group (all P < 0.01). The S/D ratios in control, A1, A2 and A3 groups increased orderly (P < 0.05). Receiver operating characteristic curve analysis demonstrated that the sensitivity and specificity of NRBC count and S/D ratios in diagnosing HDP were 96.50% and 96.28%; 93.60% and 98.14%; 94.30% and 94.88% 99.30% and 100%, respectively. Pearson and Spearman correlation analysis revealed that the NRBC and S/D ratios were correlated with gestational age at birth, amniotic fluid volume, premature birth, mechanical ventilation, neonatal intensive care unit admission, neonatal asphyxia, birth weight, fetal distress, APGAR score, pH value, arterial oxygenation tension, bicarbonate and base excess (all P < 0.05). The NRBC count was positively associated with the S/D ratios (all P < 0.05).
Our results provide evidence that NRBC count in patients with HDP increased significantly, showing positive correlations with umbilical S/D ratios.
我们研究了有核红细胞(NRBC)计数与妊娠期高血压疾病(HDP)及胎儿脐血流速度之间的相关性。
我们招募了282例HDP患者作为实验组,其中包括107例轻度子痫前期患者(A1组)、100例重度子痫前期患者(A2组)和75例子痫患者(A3组),并招募了215例正常孕妇作为对照组。采集孕妇外周静脉血,分离出的细胞用瑞氏-吉姆萨染色。我们按照实验室常规方法估算NRBC计数,并采用多普勒超声检查测量胎儿静脉导管、脐动脉和大脑中动脉的收缩/舒张(S/D)比值。
A1、A2和A3组的NRBC计数均高于对照组(均P<0.01)。对照组、A1、A2和A3组的S/D比值依次升高(P<0.05)。受试者工作特征曲线分析表明,NRBC计数和S/D比值诊断HDP的敏感性和特异性分别为96.50%和96.28%;93.60%和98.14%;94.30%和94.88%;99.30%和100%。Pearson和Spearman相关性分析显示,NRBC和S/D比值与出生孕周、羊水量、早产、机械通气、新生儿重症监护病房入院、新生儿窒息、出生体重、胎儿窘迫、阿氏评分、pH值、动脉血氧分压、碳酸氢盐和碱剩余均相关(均P<0.05)。NRBC计数与S/D比值呈正相关(均P<0.05)。
我们的结果表明,HDP患者的NRBC计数显著增加,与脐血流S/D比值呈正相关。