Pulse wave analysis: a preliminary study of a novel technique for the prediction of pre-eclampsia
Pulse wave analysis: a preliminary study of a novel technique for the prediction of pre-eclampsia
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DOI：
10.1111/j.1471-0528.2008.01906.x
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发表时间：
2009-01-01
影响因子：
5.8
通讯作者：
Harrington, K. F.
中科院分区：
文献类型：
--
作者：
Khalil, A. A.;Cooper, D. J.;Harrington, K. F.
为了研究孕早期动脉脉搏波分析（PWA）是否可以预测先兆子痫。这是一项前瞻性筛查研究。对210例低风险单胎妊娠妇女进行了分析，测量了11（+0）和13（+6）之间的桡动脉脉搏波形，妊娠周和通过应用广义传递函数导出的主动脉波形。计算心率为75次/分钟时的增强压（AP）和增强指数（AIx-75），即动脉硬度的测量值。计算对照组中AP和AIx-75的妊娠特异性中位数的倍数。Logistic回归模型的建立及其预测能力的评估使用的接收器操作曲线下面积。预测先兆子痫的AIx-75。14（6.7%）的妇女发生先兆子痫，196保持正常血压。14名妇女中有8名在妊娠34周前发生先兆子痫（早发性先兆子痫）。对于11%的假阳性率，AIx-75对所有先兆子痫病例的检出率为79%，对早发性先兆子痫的检出率为88%。
To investigate whether first-trimester arterial pulse wave analysis (PWA) can predict pre-eclampsia.This was a prospective screening study.The Homerton University Hospital, a London teaching hospital.Two hundred and ten low-risk women with a singleton pregnancy were analysed.Radial artery pulse waveforms were measured between the 11(+0) and 13(+6) weeks of gestation and the aortic waveform derived by applying a generalised transfer function. Augmentation pressure (AP) and augmentation index at heart rate of 75 beats per minute (AIx-75), measures of arterial stiffness, were calculated. The multiple of the gestation-specific median in controls for AP and AIx-75 were calculated. Logistic regression models were developed and their predictive ability assessed using the area under the receiver operator curve.Prediction of pre-eclampsia by AIx-75.Fourteen (6.7%) women developed pre-eclampsia, and 196 remained normotensive. Eight of the 14 women developed pre-eclampsia before 34 weeks of gestation (early-onset pre-eclampsia). For a false-positive rate of 11%, AIx-75 had a detection rate of 79% for all cases of pre-eclampsia and 88% for early-onset pre-eclampsia.First-trimester arterial PWA can play a significant role in understanding the pathophysiology of pre-eclampsia and may play a role in early screening.