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血小板指标作为系统性红斑狼疮孕妇围产期结局的潜在生物标志物。

Platelet ındices as potential biomarkers of perinatal outcomes in women with SLE during pregnancy.

作者信息

Akkuş Fatih, Doğru Şükran

机构信息

Department of Obstetrics and Gynecology, Division of Perinatology, Necmettin Erbakan University Medical School of Meram, Hocacihan Neighborhood, Abdulhamidhan Street, No: 3 Selçuklu, Konya, Turkey.

出版信息

Arch Gynecol Obstet. 2024 Aug;310(2):825-832. doi: 10.1007/s00404-024-07446-w. Epub 2024 Mar 29.

Abstract

AIM

This study aimed to assess the platelet parameters and their prognostic value for perinatal outcomes in pregnant women with systemic lupus erythematosus (SLE).

METHODS

This retrospective study involved 180 participants, 90 pregnant women with SLE and 90 healthy pregnant women. Clinical and demographic variables including routine first-trimester neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and platelet parameters such as platelet distribution width (PDW), mean platelet volume (MPV), plateletcrit (PCT) were compared between the groups. The perinatal outcomes of the whole study group were also compared.

RESULTS

SLE patients had lower leukocyte (p = 0.001), lymphocyte (p = 0.001) and platelet counts (p = 0.018), higher PDW (p = 0.002), MPV (p = 0.001), NLR (p = 0.008) and PLR (p = 0.015) and lower PCT (p = 0.015) than the control group. The groups had no significant difference in hemoglobin levels (p = 0.936). SLE patients had higher rates of cesarean section (p = 0.002), small for gestational age (SGA) (p = 0.019) and stillbirth (p = 0.017) and lower birth weight (p = 0.001) than the control group. PCT was a significant predictor of stillbirth with a cut-off value of 0.21, sensitivity of 64.3% and specificity of 83.3% (AUC: 0.843, p < 0.001).

CONCLUSION

Pregnant women with SLE have altered platelet parameters and increased inflammatory markers compared to healthy pregnant women. PCT is a simple and useful marker for predicting stillbirth risk in SLE pregnancies.

摘要

目的

本研究旨在评估系统性红斑狼疮(SLE)孕妇的血小板参数及其对围产期结局的预后价值。

方法

本回顾性研究纳入了180名参与者,其中90名SLE孕妇和90名健康孕妇。比较两组之间的临床和人口统计学变量,包括孕早期常规中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)以及血小板参数,如血小板分布宽度(PDW)、平均血小板体积(MPV)、血小板压积(PCT)。还比较了整个研究组的围产期结局。

结果

与对照组相比,SLE患者的白细胞(p = 0.001)、淋巴细胞(p = 0.001)和血小板计数较低(p = 0.018),PDW(p = 0.002)、MPV(p = 0.001)、NLR(p = 0.008)和PLR较高(p = 0.015),PCT较低(p = 0.015)。两组血红蛋白水平无显著差异(p = 0.936)。与对照组相比,SLE患者剖宫产率(p = 0.002)、小于胎龄儿(SGA)发生率(p = 0.019)和死产率(p = 0.017)较高,出生体重较低(p = 0.001)。PCT是死产的显著预测指标,临界值为0.21,敏感性为64.3%,特异性为83.3%(AUC:0.843,p < 0.001)。

结论

与健康孕妇相比,SLE孕妇的血小板参数发生改变,炎症标志物升高。PCT是预测SLE妊娠死产风险的一个简单且有用的指标。

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