[炎症指标及其与子痫前期严重程度的关联]

[Inflammatory indexes and their association with the severity of preeclampsia].

作者信息

Conde-Rico Emma Thalia, Naves-Sánchez Jaime, González Alma Patricia, Luna-Anguiano José Luis Felipe, Paque-Bautista Carlos, Sosa-Bustamante Gloria Patricia

机构信息

Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Gineco Pediatría No. 48, Dirección de Educación e Investigación en Salud. León, Guanajuato, México.

Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Gineco Pediatría No. 48, Servicio de Tococirugía. León, Guanajuato, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2023 Sep 18;61(Suppl 2):S178-S184.

PMID:38011647

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10773918/

Abstract

BACKGROUND

Recent studies have confirmed the relationship between some inflammatory indexes and preeclampsia (PE); however, they have not been analyzed in PE with and without severity criteria.

OBJECTIVE

To know the association between inflammatory indexes and the severity of PE.

MATERIAL AND METHODS

Analytical cross-sectional prolective study. Pregnant patients were included, divided into group 1 (PE without severity criteria); group 2 (PE with severity criteria); group 3 (normotensive pregnant women). Records were reviewed and inflammatory indexes [(neutrophil-lymphocyte ratio [NLR], platelet-lymphocyte ratio [PLR], lymphocyte-monocyte ratio [LMR] and systemic immune index [SII]) were calculated.

RESULTS

240 patients were analyzed, 80 per group; age 28 (IQR 27-29) years. A significant difference was observed between group 1, group 2 and group 3, NLR 3.29 (IQR 2.82-3.69), 3.59 (IQR 2.83-4.2) and 3.42 (IQR 3.17-3.92), respectively, p = 0.02; PLR 121.59 (IQR 103.78-132), 108.32 (IQR 92.96-127.43) 136 (IQR 115.18-157.56), respectively, p = 0.01; LMR and SII showed no difference between the groups. LMR made possible to distinguish PE with and without severity criteria, cut-off point of ≥ 3.20, sensitivity 56%, specificity 56%, AUC 0.56, p = 0.01, and cut-off point ≥ 3.24, sensitivity 58%, specificity 58%, AUC 0.57, p = 0.04, respectively; the LMR ≥ 3.24 was associated with PE without severity criteria (OR 2.02 [95%CI 1.08-3.80], p = 0.03).

CONCLUSIONS

The MLR was the only inflammatory index analyzed that was associated with the presence of PE without severity data. No inflammatory index was associated with PE with severity data.

摘要

背景

近期研究证实了一些炎症指标与子痫前期（PE）之间的关系；然而，尚未对有和没有严重程度标准的PE进行分析。

目的

了解炎症指标与PE严重程度之间的关联。

材料与方法

分析性横断面前瞻性研究。纳入孕妇，分为1组（无严重程度标准的PE）；2组（有严重程度标准的PE）；3组（血压正常的孕妇）。回顾记录并计算炎症指标[中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）和全身免疫指数（SII）]。

结果

共分析240例患者，每组80例；年龄28（四分位间距27 - 29）岁。1组、2组和3组之间观察到显著差异，NLR分别为3.29（四分位间距2.82 - 3.69）、3.59（四分位间距2.83 - 4.2）和3.42（四分位间距3.17 - 3.92），p = 0.02；PLR分别为121.59（四分位间距103.78 - 132）、108.32（四分位间距92.96 - 127.43）、136（四分位间距115.18 - 157.56），p = 0.01；LMR和SII在各组之间无差异。LMR能够区分有无严重程度标准的PE，截断点≥3.20时，敏感性56%，特异性56%，曲线下面积（AUC）0.56，p = 0.01；截断点≥3.24时，敏感性58%，特异性58%，AUC 0.57，p = 0.04；LMR≥3.24与无严重程度标准的PE相关（比值比2.02[95%置信区间1.08 - 3.80]，p = 0.03）。