| ObjectiveThis study analyzes the premorbid levels of platelet count(PC),mean platelet volume(MPV),and platelet count to platelet mean volume ratio(PC/MPV)in atypical preeclampsia patients.The purpose of this study is to investigate the changes of platelet parameters in patients with atypical preeclampsia and its clinical significance.MethodsThe study utilised a comparison control group design with three groups of 300 clinical cases.There were 100 cases in the atypical preeclampsia group(Atypical PE),preeclampsia(PE)and control group(Control Group),respectively.We analyzed the characteristics of atypical PE cases,statistically analyzed the baseline data of the three groups of patients,and analyzed the statistical differences of blood routines by analysis of variance and rank sum test.Then,Logistic regression was used to adjust the odds ratio(OR)value of the confounding factor screening independent variables,and the prediction models of atypical PE and PE were established respectively.Finally,the receiver operating characteristic curve(ROC curve)was used to compare the platelet parameters to predict the difference between PE and atypical PE.P ? 0.05 is considered statistically significant.Results1.General baseline comparison: There were no significant differences in age,maternal height and maternal history between the three groups.The weight and BMI of pregnant women in PE group and atypical PE group were both higher than those in control group(P<0.05).2.Characteristics of atypical pre-eclampsia cases: Before taking blood,in atypical PE group,10 cases of blood pressure increased,10 cases of thrombocytopenia,and 2 cases of suspected fetal distress.In the clinical diagnosis of atypical PE,67 cases showed hypertension,28 cases were positive for urinary protein,7 cases had abnormal liver function,and 5 cases had abnormal renal function.3.Comparison of blood pressure and postpartum conditions in three groups of subjects: Regardless of systolic or diastolic blood pressure,the results were PE group > atypical PE group > control group,and there was a statistically significant difference between the each two groups.There were no significant differences in gender between the three groups(P=0.936);Cesarean section rate: PE group = atypical PE group > control group;Neonatal weight: control group = atypical PE group > PE group;The volume of bleeding during 2 hours after labor: PE group = atypical PE group > control group.4.Comparison of blood routines in three groups of patients: Platelet count,PC/MPV: control group > atypical PE group = PE group.MPV: PE group > atypical PE group > control group.White blood cell count: PE group> control group,but there was no statistical difference between the typical PE group and the PE group and the control group(P=0.618 and 0.480).There were no statistically significant differences in hemoglobin between the three groups(P=0.094).5.The logistic regression model was used to adjust the confounding factors,suggesting that the pre-eclampsia PC/MPV OR was 0.892(95% CI 0.852-0.933),and the atypical preeclampsia PC/MPV OR was 0.904(95% CI 0.863-0.947).Draw a column plot based on the independent variables in the model.Finally,the ROC curve is drawn.The area under the ROC curve of the PE prediction model is 0.759,and the area under the atypical PE curve is 0.780.Conclusion:In this paper,Logistic regression was used to analyze the changes of platelet parameters before diagnosis of atypical PE and PE pregnant women.It was found that the changes of atypical PE platelet parameters were similar to PE,and the platelet parameters were found by the nomogram model to individualize the probability of occurrence of atypical PE or PE.Platelet parameters are helpful for timely diagnosis of atypical preeclampsia,choose the timing of termination of pregnancy,and have certain clinical significance in improving the maternal and neonatal outcomes. |
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