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孕早中期孕妇肠道菌群差异与子痫前期发病关系的研究

莫蕾，钟萍 * 扫描二维码
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【摘要】 背景 子痫前期病情严重者可进展至子痫并威胁母婴生命安全，而肠道菌群构成变化可能参与子痫前
期的发生、发展，但尚无明确证据。目的 探讨孕早中期孕妇肠道菌群差异与子痫前期发病的关系。方法 选取 2019
年 1 月至 2021 年 1 月桂林医学院第二附属医院产科招募且符合本研究纳入标准的孕妇 455 例。将妊娠 20 周后确诊为
子痫前期的孕妇作为子痫前期组（n=32），未发生子痫前期的孕妇作为非子痫前期组（n=423）。收集孕妇的临床资
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料，并分别留取孕早期（≤ 12 周）、孕中期（13~27 周）粪便标本进行肠道菌群生物信息学分析，分析其与子痫
前期发病的关系。结果 子痫前期组和非子痫前期组年龄、孕早期 Shannon 指数和 Simpson 指数比较，差异均有统计
学意义（P<0.05）。多因素 Logistic 回归分析结果显示，年龄≥ 35 周岁〔OR=1.894，95%CI（1.432，2.369）〕、孕早
期 Shannon 指数下降〔OR=0.709，95%CI（0.465，0.921）〕、孕早期 Simpson 指数下降〔OR=0.612，95%CI（0.354，0.893）〕
是孕妇发生子痫前期的独立危险因素（P<0.05）。孕早期 Shannon 指数预测孕妇子痫前期发病的受试者工作特征（ROC）
曲线下面积为 0.745〔95%CI（0.652，0.838）〕，截断值为 6.255，灵敏度为 76.58%，特异度为 60.00%；孕早期
Simpson 指数预测孕妇子痫前期发病的 ROC 曲线下面积为 0.724〔95%CI（0.623，0.826）〕，截断值为 0.945，灵敏度
为 62.90%，特异度为 60.61%。结论 孕早期粪便肠道菌群 Shannon 指数、Simpson 指数降低是孕妇发生子痫前期的独
立危险因素，且对子痫前期发病具有早期预测价值。
【关键词】 子痫前期；子痫；妊娠初期；妊娠中期；胃肠道微生物组；肠道菌群；孕妇
【中图分类号】 R 714.245 【文献标识码】 A DOI：10.12114/j.issn.1007-9572.2022.0188
莫蕾，钟萍 . 孕早中期孕妇肠道菌群差异与子痫前期发病关系的研究［J］. 中国全科医学，2022，25（20）：
2489-2492. ［www.chinagp.net］
MO L，ZHONG P. Study on the relationship between intestinal microflora differences and the incidence of preeclampsia in
pregnant women in the early and middle stages of pregnancy［J］. Chinese General Practice，2022，25（20）：2489-2492.

Study on the Relationship between Intestinal Microflora Differences and the Incidence of Preeclampsia in Pregnant
Women in the Early and Middle Stages of Pregnancy MO Lei，ZHONG Ping *
Department of Obstetrics，the Second Affiliated Hospital of Guilin Medical University，Guilin 541199，China
*
Corresponding author：ZHONG Ping，Chief physician；E-mail：s446fc@126.com
【Abstract】 Background Severe preeclampsia can progress to eclampsia and threaten the life safety of mothers and
infants，while intestinal flora composition changes may be involved in the occurrence and development of preeclampsia，but
there is no clear evidence. Objective To investigate the relationship between intestinal flora differences and the incidence of
preeclampsia in pregnant women in the early and middle stages of pregnancy. Methods A total of 455 pregnant women recruited
from the Department of Obstetrics，the Second Affiliated Hospital of Guilin Medical University from January 2019 to January 2021
who met the requirements were selected. Pregnant women diagnosed with preeclampsia after 20 weeks of gestation were classified
as preeclampsia group（n=32），and pregnant women without preeclampsia were classified as non-preeclampsia group（n=423）.
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The clinical data of pregnant women were collected，and fecal samples were collected in the early（≤ 12 weeks） and middle
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stages of pregnancy（13~27 weeks） for bioinformatics analysis of intestinal flora，and the relationship between bioinformatics
and the incidence of preeclampsia was analyzed. Results There were statistically significant differences in age，Shannon index
and Simpson index in early pregnancy between preeclampsia group and non-preeclampsia group（P<0.05）. Logistic regression
analysis showed that age ≥ 35 years old〔OR=1.894，95%CI（1.432，2.369）〕，low Shannon index in early pregnancy
〔OR=0.709，95%CI（0.465，0.921）〕 and low Simpson index in early pregnancy〔OR=0.612，95%CI（0.354，0.893）〕
were independent risk factors for preeclampsia（P<0.05）. ROC curve showed that the optimal cut-off value and AUC of Shannon
index for predicting the incidence of preeclampsia in pregnant women in early pregnancy were 6.255 and 0.745〔95%CI（0.652，

541199 广西壮族自治区桂林市，桂林医学院第二附属医院产科
*
通信作者：钟萍，主任医师；E-mail：s446fc@126.com
本文数字出版日期：2022-04-28