孕早期嗜酸性粒细胞计数及基于嗜酸性粒细胞的全血细胞指标在子痫前期预测中的作用：一项病例对照研究。
The role of first trimester eosinophil count and eosinophil-based complete blood cell indices in the predictiction of preeclampsia: A case-control study.
作者信息
Tanacan Atakan, Sakcak Bedri, Ipek Goksun, Agaoglu Zahid, Peker Ayca, Haksever Murat, Kara Ozgur, Sahin Dilek
机构信息
Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, University of Health Sciences, Ankara, Turkey; Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
出版信息
Placenta. 2023 Nov;143:16-21. doi: 10.1016/j.placenta.2023.09.011. Epub 2023 Sep 29.
INTRODUCTION
The importance of eosinophils in the pathogenesis of preeclampsia is an question of interest and there are recent studies in the literature indicating significantly lower eosinophil count values in pregnant women with preeclampsia. The present study aims to evaluate the utility of first-trimester eosinophil count and eosinophil-based complete blood cell count indices in the prediction of preeclampsia.
METHODS
Pregnant women diagnosed with preeclampsia (n = 281) were retrospectively compared with a control group (n = 307). The utility of first trimester eosinophil count, neutrophil to eosinophil ratio (NER) (neutrophil/eosinophil), leukocyte to eosinophil ratio (LER) (leukocyte/eosinophil), eosinophil to monocyte ratio (EMR) (eosinophil/monocyte) and, eosinophil to lymphocyte ratio (ELR) (eosinophil/lymphocyte) in the prediction of preeclampsia were evaluated.
RESULTS
Optimal cut-off values for eosinophil count, NER, LER, EMR and, ELR in predicting preeclampsia were 0.07 (AUC: 0.62, 58.7% sensitivity, 56.4% specificity), 90.9 (AUC: 0.65, 61.1% sensitivity, 59.4% specificity), 125.7 (AUC: 0.64, 61.4% sensitivity, 58.4% specificity), 0.15 (AUC: 0.63, 60.1% sensitivity, 59.6% specificity) and, 0.03 (AUC: 0.62, 60.9% sensitivity, 57% specificity), respectively. Mentioned values in predicting early-onset preeclampsia were 0.07 (AUC: 0.64, 60.5% sensitivity, 50.8% specificity), 102.1 (AUC: 0.64, 62.4% sensitivity, 58.8% specificity), 140.2 (AUC: 0.65, 63.5% sensitivity, 59.1% soecificity), 0.14 (AUC: 0.66, 66.3% sensitivity, 59.2% specificity), and, 0.03 (AUC: 0.63, 60.5% sensitivity, 57.4% specificity), respectively. The optimal cut-off value for EMR in the prediction of preeclampsia with severe features was 0.16 (AUC: 0.56, 56.9% sensitivity, 53.2% specificity).
DISCUSSION
Eosinophil-based complete blood count indices may be used to predict early-onset preeclampsia with relatively low sensitivity and specificity.
引言
嗜酸性粒细胞在子痫前期发病机制中的重要性是一个备受关注的问题，近期文献研究表明，子痫前期孕妇的嗜酸性粒细胞计数显著降低。本研究旨在评估孕早期嗜酸性粒细胞计数及基于嗜酸性粒细胞的全血细胞计数指标在预测子痫前期中的作用。
方法
对281例诊断为子痫前期的孕妇与307例对照组孕妇进行回顾性比较。评估孕早期嗜酸性粒细胞计数、中性粒细胞与嗜酸性粒细胞比值（NER）（中性粒细胞/嗜酸性粒细胞）、白细胞与嗜酸性粒细胞比值（LER）（白细胞/嗜酸性粒细胞）、嗜酸性粒细胞与单核细胞比值（EMR）（嗜酸性粒细胞/单核细胞）以及嗜酸性粒细胞与淋巴细胞比值（ELR）（嗜酸性粒细胞/淋巴细胞）在预测子痫前期中的作用。
结果
嗜酸性粒细胞计数、NER、LER、EMR和ELR预测子痫前期的最佳截断值分别为0.07（曲线下面积[AUC]：0.62，灵敏度58.7%，特异度56.4%）、90.9（AUC：0.65，灵敏度61.1%，特异度59.4%）、125.7（AUC：0.64，灵敏度61.4%，特异度58.4%）、0.15（AUC：0.63，灵敏度60.1%，特异度59.6%）和0.03（AUC：0.62，灵敏度60.9%，特异度57%）。上述指标预测早发型子痫前期的值分别为0.07（AUC：0.64，灵敏度60.5%，特异度50.8%）、102.1（AUC：0.64，灵敏度62.4%，特异度58.8%）、140.2（AUC：0.65，灵敏度63.5%，特异度59.1%）、0.14（AUC：0.66，灵敏度66.3%，特异度59.2%）和0.03（AUC：0.63，灵敏度60.5%，特异度57.4%）。EMR预测重度子痫前期的最佳截断值为0.16（AUC：0.56，灵敏度56.9%，特异度53.2%）。
讨论
基于嗜酸性粒细胞的全血细胞计数指标可用于预测早发型子痫前期，但其灵敏度和特异度相对较低。
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