应用ROC曲线分析肝内胆汁淤积症孕妇血甘胆酸预测胎儿窘迫的最佳临界值

发布时间：2018-06-11 14:57

  本文选题：胆汁淤积 + 肝内　； 参考：《中国现代医学杂志》2015年01期

【摘要】：目的探讨肝内胆汁淤积症孕妇血甘胆酸预测胎儿窘迫的最佳临界值。方法回顾性分析96例ICP孕妇血甘胆酸与胎儿窘迫发生与否的关系,应用ROC曲线寻找和确定用于预测胎儿窘迫的甘胆酸最佳临界值。结果妊娠肝内胆汁淤积症发生胎儿窘迫孕妇血清甘胆酸均值为28.65μg/ml,高于未发生胎儿窘迫血清甘胆酸水平17.78μg/ml,两组差异具有统计学意义(P0.001)。依据敏感度与特异度之和最大化原则计算预测胎儿窘迫的甘胆酸临界值23.60μg/ml,ROC曲线下面积可达0.875,面积的95%可信区间为(0.794,0.956)。以23.60μg/ml界值预测胎儿窘迫吻合系数为0.592,敏感度81.00%,特异85.30%,阴性预测值0.941,阳性预测值0.607(P0.001)。结论血清甘胆酸水平是预测妊娠期肝内胆汁淤积症孕妇是否发生胎儿窘迫的一项重要指标,随着甘胆酸水平的升高,胎儿窘迫的发生率逐渐增加,当血清甘胆酸≥23.60μg/ml时应加强胎儿宫内监护,及时终止妊娠,降低围生儿病率。
[Abstract]:Objective to study the optimal critical value of serum glycine cholic acid in predicting fetal distress in pregnant women with intrahepatic cholestasis. Methods the relationship between serum glycholic acid and fetal distress in 96 ICP pregnant women was analyzed retrospectively. The optimal critical value of glycine cholic acid for predicting fetal distress was found and determined by ROC curve. Results the mean value of serum glycholic acid in pregnant women with fetal distress in intrahepatic cholestasis was 28.65 渭 g / ml, which was higher than that in non-fetal distress group (17.78 渭 g / ml). The difference between the two groups was statistically significant (P 0.001). According to the principle of maximum sum of sensitivity and specificity, the critical value of glycolic acid for predicting fetal distress was 23.60 渭 g / ml / ml ~ (-1) ROC curve, and the area under ROC curve was 0.875, and the 95% confidence interval of area was 0.794 ~ 0.956%. The coefficient of fetal distress anastomosis predicted by 23.60 渭 g/ml was 0.592, the sensitivity was 81.00, the specificity was 85.300.The negative predictive value was 0.941, the positive predictive value was 0.607g / P 0.001. Conclusion Serum cholic acid level is an important index to predict fetal distress in pregnant women with intrahepatic cholestasis of pregnancy. When serum cholic acid 鈮，

本文编号：2005681