應(yīng)用ROC曲線分析肝內(nèi)膽汁淤積癥孕婦血甘膽酸預(yù)測胎兒窘迫的最佳臨界值
發(fā)布時間:2018-06-11 14:57
本文選題:膽汁淤積 + 肝內(nèi)。 參考:《中國現(xiàn)代醫(yī)學(xué)雜志》2015年01期
【摘要】:目的探討肝內(nèi)膽汁淤積癥孕婦血甘膽酸預(yù)測胎兒窘迫的最佳臨界值。方法回顧性分析96例ICP孕婦血甘膽酸與胎兒窘迫發(fā)生與否的關(guān)系,應(yīng)用ROC曲線尋找和確定用于預(yù)測胎兒窘迫的甘膽酸最佳臨界值。結(jié)果妊娠肝內(nèi)膽汁淤積癥發(fā)生胎兒窘迫孕婦血清甘膽酸均值為28.65μg/ml,高于未發(fā)生胎兒窘迫血清甘膽酸水平17.78μg/ml,兩組差異具有統(tǒng)計(jì)學(xué)意義(P0.001)。依據(jù)敏感度與特異度之和最大化原則計(jì)算預(yù)測胎兒窘迫的甘膽酸臨界值23.60μg/ml,ROC曲線下面積可達(dá)0.875,面積的95%可信區(qū)間為(0.794,0.956)。以23.60μg/ml界值預(yù)測胎兒窘迫吻合系數(shù)為0.592,敏感度81.00%,特異85.30%,陰性預(yù)測值0.941,陽性預(yù)測值0.607(P0.001)。結(jié)論血清甘膽酸水平是預(yù)測妊娠期肝內(nèi)膽汁淤積癥孕婦是否發(fā)生胎兒窘迫的一項(xiàng)重要指標(biāo),隨著甘膽酸水平的升高,胎兒窘迫的發(fā)生率逐漸增加,當(dāng)血清甘膽酸≥23.60μg/ml時應(yīng)加強(qiáng)胎兒宮內(nèi)監(jiān)護(hù),及時終止妊娠,降低圍生兒病率。
[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,
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