【摘要】 目的分析广西地区妊娠高血压综合征(PIH)发生的危险因素,并建立PIH的风险预测模型。方法纳入广西出生队列中的2 606例孕妇为研究对象,其中PIH孕妇173例(PIH组),健康孕妇2 433例(对照组)。采用Logistic回归模型分析PIH发生的危险因素,并根据分析结果构建风险预测模型。应用受试者工作特征(ROC)曲线对模型的预测效能进行检验,并抽取20%的研究样本代入方程进行进一步验证。结果高龄、初产妇、月经不规律、孕20周前收缩压升高是PIH发生的危险因素(均P <0. 05)。建立PIH的预测模型为:Logit P=-10. 392+0. 040×X1+0. 593×X2+0. 429×X3+0. 055×X4。该模型预测PIH的ROC曲线下面积为0. 689,灵敏度为78. 4%,特异度为54. 5%。抽取样本验证结果显示,该模型预测PIH的灵敏度为73. 5%,特异度为48. 3%,Kappa值=0. 051 (P=0. 013),一致性较差。结论高龄、初产妇、月经不规律、孕20周前收缩压升高的孕妇发生PIH的风险增高。所建立模型对广西地区孕妇发生PIH的预测能力一般。更多还原

【Abstract】 Objective To analyze the risk factors for developing pregnancy-induced hypertension syndrome( PIH) in Guangxi region,and to establish a risk prediction model for PIH. Methods A total of 2 606 pregnant women from Guangxi birth cohort were enrolled,including 173 pregnant women with PIH( PIH group) and 2 433 healthy pregnant women( control group). Logistic regression model was used to analyze the risk factors for developing PIH,and the risk prediction model was established according to the result of the analysis. The predictive efficiency of the model was verified using receiver operating characteristic( ROC) curve,and 20% of the objects were sampled and substituted into the equation for further verification. Results Advanced age,primipara,irregular menstruation,and elevated systolic blood pressure before 20 gestational weeks were the risk factors for developing PIH( all P < 0. 05).The risk prediction model for PIH was Logit P =-10. 392 + 0. 040 × X1+ 0. 593 × X2+ 0. 429 × X3+ 0. 055 × X4.The area under ROC curve,sensitivity and specificity of the model for predicting PIH were 0. 689,78. 4% and 54. 5%,respectively. The result of the verification by sampling showed that a poorer consistency( Kappa value = 0. 051,P = 0. 013) was found in the model for predicting PIH with a sensitivity and a specificity of 73. 5% and 48. 3%,respectively. Conclusion The risk for developing PIH is higher in pregnant women with advanced age,of primipara,with irregular menstruation,or with elevated systolic blood pressure before 20 gestational weeks. The model established obtains a general predictive efficiency for developing PIH in Guangxi pregnant women.更多还原