国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (18): 3107-3111.DOI: 10.3760/cma.j.cn441417-20241014-18023

• 护理研究 • 上一篇    下一篇

早发型子痫前期患者确诊时妊娠终止的影响因素研究

王利  郭珍珍  孙宏跃   

  1. 郑州市妇幼保健院产科,郑州 450000

  • 收稿日期:2024-10-14 出版日期:2025-09-15 发布日期:2025-09-28
  • 通讯作者: 王利,Email:yu15136173903@163.com
  • 基金资助:

    河南省医学科技攻关计划联合共建项目(LHGJ20220875)

Study on the influencing factors of termination of pregnancy upon diagnosis of early onset preeclampsia

Wang Li, Guo Zhenzhen, Sun Hongyue   

  1. Department of Obstetrics, Women & Infants Hospital of Zhengzhou, Zhengzhou 450000, China

  • Received:2024-10-14 Online:2025-09-15 Published:2025-09-28
  • Contact: Wang Li, Email :yu15136173903@163.com
  • Supported by:

    Joint Construction Project of Henan Medical Science and Technology Research Plan ( LHGJ20220875 )

摘要:

目的 分析早发型子痫前期(early onset preeclampsia,EOPE)患者确诊时选择妊娠终止的影响因素。方法 采用回顾性分析,收集2021年3月至2024年3月郑州市妇幼保健院确诊的103例重度EOPE患者临床资料,根据患者确诊时是否选择妊娠终止分为终止组(31例)与妊娠组(72例),终止组年龄(30.42±3.06)岁,妊娠组年龄(29.67±3.04)岁。采用t检验、χ2检验进行统计比较,单因素、多因素logistic回归分析重度EOPE患者确诊时选择妊娠终止的相关因素,绘制受试者操作特征曲线(ROC)、校准曲线评价模型价值。结果 多因素logistic回归分析显示,合并严重并发症(OR=3.363)、血小板进行性下降(OR=6.535)、D-二聚体水平较高(OR=9.296)、胱抑素C水平较高(OR=13.205)及脑胎盘比较低(OR=0.005)是重度EOPE患者确诊时选择妊娠终止的相关因素(均P<0.05)。根据上述因素构建风险预测模型显示,模型的曲线下面积为0.873,且模型校准度较好。结论 合并严重并发症、血小板进行性下降、D-二聚体水平较高、胱抑素C水平较高及脑胎盘比较低是重度EOPE患者确诊时选择妊娠终止的相关因素,构建的风险预测模型具有良好预测价值。

关键词:

妊娠终止, 早发型子痫前期, 影响因素, 预测模型

Abstract:

Objective To analyze the influencing factors for pregnancy termination decisions in patients diagnosed with early-onset preeclampsia (EOPE). Methods A retrospective analysis was conducted using colored pens to collect clinical data of 103 patients with severe EOPE diagnosed at Women & Infants Hospital of Zhengzhou from March 2021 to March 2024. The patients were divided into a termination group (31 cases) and a pregnancy group (72 cases) based on whether they chose to terminate their pregnancy at the time of diagnosis. The termination group had an age of (30.42±3.06) years, while the pregnancy group had an age of (29.67±3.04) years. Statistical comparison was conducted using t test and χ2 test, and univariate and multivariate logistic regression analyses were conducted to identify the relevant factors for selecting pregnancy termination in patients with severe EOPE upon diagnosis. Receiver Operating Characteristic curves (ROC) and calibration curves were plotted to evaluate the value of the model. Results Multiple logistic regression analysis showed that the presence of severe complications (OR=3.363), progressive thrombocytopenia (OR=6.535), high levels of D-dimer (OR=9.296), high levels of cystatin C (OR=13.205), and low cerebral placental ratio (OR=0.005) were the relevant factors for choosing to terminate pregnancy in patients with severe EOPE upon diagnosis (all P<0.05). The risk prediction model constructed based on the above factors showed that the area under the curve of the model was 0.873, and the model calibration was good. Conclusions The combination of severe complications, progressive thrombocytopenia, high levels of D-dimer, high levels of cystatin C, and low brain placental ratio are relevant factors for the selection of pregnancy termination in patients with severe EOPE diagnosis. The risk prediction model constructed has good predictive value.

Key words:

Early-onset preeclampsia, Pregnancy termination, Influencing factors, Predictive model