摘要
目的探讨子痫前期女性血清可溶性内皮因子(sEng)水平与子痫前期的严重程度和临床结局的相关性。方法选取2017年5月-2019年10月在邯郸市中心医院诊断为子痫前期的1002例单胎妊娠女性作为研究对象。另选择同期150例妊娠期间血压正常的健康单胎妊娠女性作为对照组(第1组)。1002例子痫前期女性按照疾病的严重程度分为:第2组:轻度子痫前期患者(n=238);第3组:重度子痫前期患者(n=528);第4组:子痫患者(n=236)。采用ELISA法测定血清sEng水平。另外,依据血清sEng四分位数间距把1002例子痫前期患者分为4组,即Quart 1组、Quart 2组、Quart 3组和Quart 4组。分析血清sEng水平与子痫前期的严重程度、临床和实验室参数以及不良结局之间的关系。结果第1、2、3、4组各组间血清sEng水平差异均有统计学意义(P<0.001)。所有子痫前期患者血清sEng的整体水平与正常妊娠女性比较差异有统计学意义(P<0.001)。血清sEng水平与孕龄、婴儿出生体质量和血小板计数呈显著负相关(P<0.001);与血压、尿蛋白/肌酐比值、肌酐水平、尿酸、谷草转氨酶(AST)、谷丙转氨酶(ALT)和低密度脂蛋白(LDH)呈显著正相关(P<0.001)。Quart 4组所有不良围产结局的风险均最高(OR值均在3.1以上)。此外,合并胎盘早剥、血小板减少、肝功能异常和34周前早产的风险随着sEng水平四分位数的增加而逐渐升高。Quart 3组和Quart 4组患者中,急性肾功能衰竭、需要肌力药物支持、气管插管的例数逐渐增加。Quart 4组的女性出现肺水肿、肝包膜下血肿或破裂、需要血液透析、脑出血或孕产妇死亡的风险最高。相对于Quart 1组,Quart 2、Quart 3组和Quart 4组女性产出小于胎龄儿(SGA)的OR值逐渐增加。Quart 2、Quart 3和Quart 4组分别较Quart 1组的早产风险增加了1.75、2.30、2.33倍。结论血清sEng水平与子痫前期的严重程度、不良结局以及临床和实验室参数�
Objective To investigate the correlation between serum serum soluble endoglin(sEng)levels in women with preeclampsia and the severity and prognosis of preeclampsia.Methods Atotal of1002 singleton pregnant women diagnosed with preeclampsia at our hospital between May 2017 and October 2019 were studied.Another 150 healthy singleton pregnant women with normal blood pressure during pregnancy were selected as control group(group 1).The women with preeclampsia were divided into two groups according to the severity of the disease:group 2(patients with mild preeclampsia,n=238),group 3(patients with severe preeclampsia,n=528),andgroup 4(patients with eclampsia,n=236).The serum sEng level was determined by ELISA.In addition,a sample of 1002 preeclampsia patients was divided into four groups based on the interquartile spacing of serum sEng,namely,Quart 1,Quart 2,Quart 3 and Quart 4.The relationship between serum sEng levels and severity of preeclampsia,clinical and laboratory parameters,and adverse outcomes was analyzed.Results There was a statistical significance in serum sEng level between the preeclampsia patients and normal pregnant women(P<0.001).There was a significant negative correlation between theserum sEng level and gestational age,birth weight and platelet count(P<0.001).Blood pressure,urinary protein/creatinine ratio,creatinine level,uric acid,AST,ALT,and LDH were positively correlated(P<0.001).The risk of adverse perinatal outcomes was highest in the Quart 4 group(OR value was above 3.1).In addition,the risk of concomitant placental abolitions,thrombocytopenia,liver dysfunction,and preterm delivery before 34 weeks increased with the increase in the sEng level quartile.In Quart 3 and Quart 4,the number of patients with acute renal failure,requiring muscular support,and endotracheal intubation increased gradually.Women in the Quart 4 group had the highest risk of developing pulmonary edema,subcapsular hematoma or rupture,requiring hemodialysis,cerebral hemorrhage,or maternal death.Compared with the Quart 1group,
作者
孙晓琳
张平
韩丹
韩卫华
纪月华
冯海芹
SUN Xiaolin;ZHANG Ping;HAN Dan;HAN Weihua;Ji Yuehua;FENG Haiqin(Obstetrics department of Handan Central Hospital, Handan Hebei 056001, China)
出处
《新疆医科大学学报》
CAS
2020年第9期1218-1223,共6页
Journal of Xinjiang Medical University
基金
河北省卫生健康委医学研究计划项目(20190167)。
