Study On Correlation Between Peripheral Blood Inflammatory Indexes,Platelet Parameters,Coagulation Indexes And Preeclampsia

Objective: To investigate the changes of peripheral blood inflammatory markers,platelet parameters and coagulation markers in the first trimester of pregnancy in patients with preeclampsia,to study the relationship between the changes and preeclampsia,to establish a prediction model,and to evaluate the predictive value of the combined index of the indicators for preeclampsia.Methods: According to the inclusion and exclusion criteria,100 cases of preeclampsia(observation group)and 100 normal pregnant women(control group)who were hospitalized in the First Affiliated Hospital of Xinjiang Medical University and delivered in the obstetrics department of our hospital from December 2020 to December 2022 were selected according to the inclusion and exclusion criteria.The early peripheral blood inflammatory indicators(neutrophil count,lymphocyte count),platelet parameters(platelet count,mean platelet volume,thrombocytocrit,mean platelet distribution width),coagulation indicators(plasma prothrombin time),plasma fibrinogen,activated partial thromboplastin time,thrombin time)of the two groups were collected and recorded The indicators with significant statistical differences were used as independent variables,and the occurrence of preeclampsia was used as the dependent variable for Logistic regression to establish a prediction model.The ROC curve was drawn to evaluate the diagnostic value of the above indicators independently and in combination for patients with preeclampsia.Results: There were significant differences in gestational age,BMI,systolic blood pressure and diastolic blood pressure between the two groups,and the observation group was significantly higher than the control group(P < 0.05).There were no significant differences in age and gravidity between the two groups(P>0.05).There were significant differences in NLR,PLR,PLT/MPV,PT,FIB and APTT between the two groups.The NLR of the observation group was significantly higher than that of the control group,and the PLR,PLT/MPV,PT,FIB and APTT of the observation group were significantly lower than those of the control group.There was no significant difference in PCT/MPV between the two groups(P>0.05).After excluding indicators with collinearity and adjusting for gestational age,BMI,systolic blood pressure,diastolic blood pressure and other indicators,it was found that NLR,PLT/MPV and PT were significantly correlated with the occurrence of preeclampsia(P < 0.05).The presence or absence of preeclampsia was used as the dependent variable,and NLR,PLT/MPV and PT were used as independent variables for binary logistic regression.NLR was found to be an independent risk factor for preeclampsia(OR>1).For every unit increase in NLR,the probability of preeclampsia increased by 0.614 times(OR=1.614).PLT/MPV and PT were independent protective factors for preeclampsia(OR < 1).For every 1 unit increase in PLT/MPV,the probability of preeclampsia decreased by 0.137 times(OR=0.873).For every 1s increase in PT,the probability of preeclampsia decreased by 0.770(OR=0.230).PLR,FIB and APTT were not independent risk factors for preeclampsia(P>0.05).In order to further obtain the diagnostic value of NLR,PLT/MPV and PT for the occurrence of preeclampsia,the ROC curve analysis was drawn,and the results are shown in Table 5:the area under the curve of NLR was 0.711,the diagnostic sensitivity was 0.880,the specificity was 0.450,and the cut-off value was 3.546.When the area under the curve of PLT/MPV was 0.712,the diagnostic sensitivity was 0.590,the specificity was 0.770,and the cut-off value was 23.236.When the area under the curve of PT was 0.787,the diagnostic sensitivity was 0.830,and the specificity was 0.650,the cut-off value was9.650 s.The predictive model Y= 0.512 x NLR-0.099 x PLT/MPV-1.516 x PT was established by NLR,PLT/MPV and PT,and the ROC curve was drawn.The sensitivity of NLR combined with PLT/MPV was 0.760.The specificity of PLT/MPV combined with PT was high,which was 0.860.The area under the ROC curve of NLR,PT/MPV and PT was 0.848,the sensitivity was 0.750,the specificity was 0.860,and the Youden index was0.610.Conclusion: The increase of NLR and the decrease of PLT/MPV and PT in maternal peripheral blood in the first trimester are significantly correlated with the occurrence of preeclampsia.The prediction model Y= 0.512 x NLR-0.099 x PLT/ MPV-1.516 x PT established by the combination of the three factors can be used for early identification of preeclampsia.