| Purpose:The aim of this study was to analyze the differences in the expression of platelet parameters and coagulation indices in the peripheral blood of pregnant women with preeclampsia and normal pregnancy,and to investigate their correlation and predictive value with the onset of preeclampsia and preterm delivery.Methods: A total of 214 pregnant women who had regular obstetric checkups at Qingdao Municipal Hospital and delivered in our hospital from October 2020 to December 2022 were selected for the study,according to the inclusion and exclusion criteria.In the observation group,there were 107 pregnant women who fully met the diagnostic criteria for preeclampsia,including 54 cases of "mild" preeclampsia(mild group)and 53 cases of "severe" preeclampsia(severe group).At the same time,107 healthy pregnant women who delivered at the same time in our hospital were randomly selected as the control group(normal group).(1)Clinical data of the study subjects were collected,including age,gestational age,gestational age at delivery,time of first elevation of blood pressure,admission blood pressure and neonatal weight,neonatal length,neonatal body mass index and preterm birth,and compared.(2)Laboratory tests were analyzed to compare the differences in the levels of platelet parameters(platelet count PLT,platelet pressure volume PCT,mean platelet pressure volume MPV,platelet distribution width PDW)in the peripheral blood of the three groups of pregnant women.(3)Laboratory tests were analyzed to compare the differences in the levels of coagulation parameters(prothrombin time PT,partially activated prothrombin time APTT,fibrinogen FIB,prothrombin time TT,and D-dimer quantification)in the peripheral blood of the three groups of pregnant women.(4)The D-dimer/platelet ratio DPR was calculated,and the three groups were analyzed for comparison.(5)Spearman correlation analysis and logistic regression analysis were used to screen platelet parameters and coagulation indexes associated with the onset of preeclampsia,and ROC curves were plotted to explore their predictive value in the onset of preeclampsia.(6)Spearman correlation analysis and logistic regression analysis were used to screen platelet parameters and coagulation indexes associated with preterm delivery in preeclampsia.Results:(1)The differences in maternal age and gestational age between the three groups were not statistically significant,P<0.05.The maternal age at delivery was significantly lower in the mild and severe groups than in the normal group,P < 0.05,and the difference was statistically significant;the lowest in the severe group.The maternal blood pressure on admission was significantly higher in the mild and severe groups than in the normal group,P < 0.05,and the difference was statistically significant;the highest in the severe group.Neonatal weight,neonatal length and neonatal body mass index were significantly lower in the mild and severe groups than in the normal group,P<0.05,with a statistically significant difference,and the lowest in the severe group.The first elevated gestational week of blood pressure of pregnant women in the severe group was significantly lower than that in the mild group,P<0.05,and the difference was statistically significant.The incidence of preterm delivery in the three groups of pregnant women was compared,P < 0.05,and the difference was statistically significant.(2)When comparing PLT in the observation group with the normal group,the difference was statistically significant,P<0.05;when comparing MPV and PDW in the observation group with the normal group,the difference was statistically significant,P < 0.05,and MPV and PDW in the severe group were significantly higher than those in the mild group and the normal group;when comparing PCT in the observation group with the normal group,the difference was statistically significant,P<0.05.(3)When comparing APTT in the observation group with the normal group,the difference was not statistically significant,P < 0.05;when comparing PT in the observation group with the normal group,the difference was statistically significant,P< 0.05,and PT in the severe group was significantly lower than that in the mild group and normal group;when comparing TT and D-dimer in the observation group with the normal group,the difference was statistically significant,P<0.05,and TT and D-dimer in the severe group were significantly higher than that in the mild group,normal group;the difference was statistically significant when comparing the FIB of the observation group with the normal group,P<0.05.(4)The difference between the DPR of the observation group and the control group was statistically significant,P < 0.05,and the DPR of the severe group was significantly higher than that of the mild and normal groups.(5)MPV,PDW,D-dimer,TT and DPR were positively correlated with the onset of PE,r=0.360,0.328,0.393,0.473,0.366,P<0.05;PT was negatively correlated with the onset of PE,r=-0.311,P < 0.05.The OR of MPV was found to be 1.921 by logistic regression analysis,P = 0.017;the OR of PDW was 1.434,P = 0.004;the OR of PT was 0.231,P = 0.000;the OR of TT was 4.029,P = 0.000;the OR of DPR was1.513,P = 0.000.The ROC curve suggested that the AUC values of MPV,PDW,TT,DPR,and D-dimer were > 0.6 had predictive value for PE;when the optimal cut-off value of TT was 16.35 s,the area under the curve was 0.781,and the sensitivity of predicting PE was 69% and the specificity was 77%.When PT+TT+DPR were combined,the area under the curve was 0.871,the sensitivity was 69%,and the specificity was 93%,and the predictive value of this combined index was significantly higher than that of a single index.6.Logistic regression analysis of the factors for the onset of PE revealed an OR of 1.921 for MPV,P=0.017;1.434 for PDW,P=0.004;0.231 for PT,P=0.000;4.029 for TT,P=0.000;1.513 for DPR,P=0.000.(6)PDW,D-dimer,TT,and DPR were positively correlated with the occurrence of preterm labor in PE,r=0.222,0.328,0.207,0.265,0.187,P<0.05;PT was negatively correlated with the occurrence of preterm labor in PE,r=-0.263,P< 0.05.Logistic regression analysis revealed that the OR of PDW was 1.358,95% CI CI of1.151-1.603,P=0.000;the OR of PT was 0.439,95% CI of 0.281-0.685,P=0.000;the OR of TT was 1.638,95% CI of 1.148-2.338,P=0.007.Conclusion: 1.Platelet parameters,function and activity are altered during the onset of pre-eclampsia.2.Changes in coagulation indexes and D-dimer/platelet absolute ratio during the onset of preeclampsia.3.Changes in PDW,PT and TT levels in peripheral blood of pregnant women with preeclampsia correlate with the occurrence of preterm labor in PE.4.The levels of MPV,PDW,PT,TT and DPR in the peripheral blood of pregnant women have predictive value for the occurrence of preeclampsia,and the combined predictive value is better than the single predictive value. |
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