The Value Of The Difference Of Hematocrit And Plasma Albumin In Differential Diagnosis Of Pre-eclampsia/Eclampsia Syndrome

Objectives:To observe the alteration of hemoglobin(HB), Hematocrit(HCT), Albumin(ALB), Globulin(GLB), the ratio of Albumin and Globulin(ALB/GLB) and Plasma colloid osmotic pressure(COP) in pregnant women. To investigate the value of the difference of HCT and ALB in differential diagnosis of pre-eclampsia/eclampsia.Methods:A case-control study was used in this study, all cases were divided into four parts:The first part(group 1)including 170 normal examination female was from Kunming physical examination center, aged between 20-40 years old, collected the inspectors’data of HB, HCT, ALB, GLB, height, weight; the second part(group 2) including 125 cases of normal delivery parturient from the first Affiliated hospital of Kunming Medical University, aged between 21-37 years, collected the inspectors’ data of HB, HCT, ALB, GLB, height, weight and gestational weeks; the third part(group 3) including 70 patients diagnosed as gestational hypertension and 35 patients diagnosed as chronic hypertension in pregnancy from the department of obstetrics in the first Affiliated hospital of Kunming Medical University, aged between 26-36 years old, collected the inspectors’data of HB, HCT, ALB, GLB, height, weight and gestational weeks; The fourth part(group 4)including 109 patients between January 2003 and October 2015, diagnosed as pre-eclampsia/eclampsia syndrome and transferred to the intensive care unit after delivery in the first Affiliated hospital of Kunming Medical University, aged between 17-43 years old, collected the patients’data of HB, HCT, ALB, GLB at the same time point before delivery. Then calculated the difference of HCT and ALB, the ratio of ALB and GLB and the value of COP of every subjects. Established the databases of the four parts with EXCEL, using SPSS 21.0 statistical software for data analysis, the data of HB, HCT, ALB, GLB, HCT-ALB, ALB/GLB and COP between groups were compared. Identify the meaningful index to pre-eclampsia/eclampsia, and estimated approximate diagnosis threshold.Results:1.To compare with the group 1,the mean value of HB, HCT, ALB, ALB/GLB and COP in group 2 and 3 are lower (P<0.01), the mean value of HCT-ALB and GLB in group 2 and 3 are higher (P<0.01); The mean value of HCT-ALB in group 4 are higher (P<0.01), the mean value of ALB、ALB/GLB and COP in group 4 are lower (P<0.01).2.To compare with the group 2, the mean value of HB, HCT, HCT-ALB in group 4 are higher (P<0.01), the mean value of ALB, GLB and COP in group 4 are lower, the mean value of ALB/GLB in group 4 are lower(P<0.05).3.To compare with the group 3, the mean value of HB, HCT and HCT-ALB in group 4 are higher (P<0.01), the mean value of ALB, GLB, COP in group 4 are lower.4.Use the data of group 2 and 3 as the gold reference standard to draw the ROC curve of HB-ALB of group 4 respectively, the area under the curve are 0.786 and 0.804 respectively, the biggest Youden index are 0.562 and 0.574 respectively, and the corresponding dividing value are 12.95(sensitivity 57%, specificity 99.2%)and 12.65(sensitivity 58.1%, specificity 98.9%) respectively.Conclusions:1. The value of the difference of HCT and ALB of the normal pregnancy, gestational hypertension and chronic hypertension with pregnancy, pre-eclampsia/eclampsia syndrome are higher;2. When HCT-ALB> 12.65, it can help to differentiate gestational hypertension or chronic hypertension in pregnancy from pre-eclampsia/eclampsia.