| 潘自华.妊娠高血压病人尿蛋白 /肌酐比值、血浆 D-二聚体水平与不良妊娠结局关系研究[J].安徽医药,2021,25(12):2487-2490. |
| 妊娠高血压病人尿蛋白 /肌酐比值、血浆 D-二聚体水平与不良妊娠结局关系研究 |
| The relationship between ACR, D-D values and adverse pregnancy outcomes in patients with hypertension during pregnancy |
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| DOI：10.3969/j.issn.1009-6469.2021.12.036 |
| 中文关键词: 妊娠高血压 尿蛋白 肌酐 D-二聚体 妊娠结局 |
| 英文关键词: Hypertension during pregnancy Urine protein Creatinine D-dimer Pregnancy outcome |
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| 中文摘要: |
| 目的探讨妊娠高血压妇女尿蛋白 /肌酐比值( urine albumin creatinine ratio，ACR)、血浆 D-二聚体水平与不良妊娠结局的关系。方法选取 2015年 7月至 2018年 2月北京市通州区妇幼保健院确诊的妊娠高血压妇女 97例进行回顾性研究，根据其妊娠结局分为不良组 59例、未出现不良妊娠结局妇女 38例(对照组)；对比分析两组孕晚期的 ACR值、血浆 D-二聚体、血压、降压药物应用史、孕次、产次、孕前体质量指数( BMI)等资料，采用 logistic回归分析法探讨 ACR值、 D-二聚体值对妊娠高血压妇女不良妊娠结局的实际影响情况。结果不良组的 ACR值( 34.81±9.30)g/mol、D-二聚体值( 3.61±1.10)mg/L均高于对照组的( 28.77±6.95)g/mol、(2.24±0.87)mg/L(P=0.01，P<0.01)；不良组的 24 h平均收缩压( 24 h SBP)(155.8±8.4)mmHg、24 h平均舒张压( 24 h DBP)(102.1±5.1)mmHg、24 h收缩压变异性( 24 h SBPV)(0.13±0.05)、 24 h舒张压变异性( 24 h DBPV)(0.12±0.04)测定值均高于对照组( 150.3±8.1)mmHg、(98.1±5.7)mmHg、(0.10±0.04)、(0.09±0.05)(P=0.002，P=0.001，P=0.002，P=0.002)；不良组的降压药物应用史、孕前 BMI、年龄与对照组差异无统计学意义( P>0.05)；不良组的尿蛋白定量、剖宫产率、发病孕周、终止孕周与对照组比较，差异无统计学意义( P>0.05)；经 logistic回归分析， ACR值、 D-二聚体、 24 h SBP、24 h DBP、24 h SBPV、24 h DBPV、24 h尿蛋白定量水平增高将增大妊娠高血压妇女不良妊娠结局的风险(P<0.05)。结论妊娠高血压妇女的妊娠结局受到多种因素的影响， ACR、血浆 D-二聚体增高是其发生不良妊娠结局的危险因素。 |
| 英文摘要: |
| Objective To investigate the relationship between urinary albumin creatinine ratio (ACR), plasma D-dimer (D-D) levels and adverse pregnancy outcomes in women with hypertensive disorder complicating pregnancy.Methods A retrospective study was performed in 97 women with pregnancy-induced hypertension diagnosed in Maternal and Child Health Hospital in Tongzhou District ofBeijing from July 2015 to February 2018. According to the pregnancy outcome, patients were assigned into adverse pregnancy outcomegroup (n=59) and non-adverse pregnancy outcome group (control group, n=38). A comparison was made of the third-trimester ACR value, plasma D-D, blood pressure, history of antihypertensive drug use, gravidity, parity, pre-pregnancy body mass index (BMI) between thetwo groups, and logistic regression analysis was made to explore the actual impact of ACR and DD values on adverse pregnancy outcomesin pregnant women with hypertension.Results The ACR value and DD value [(34.81±9.30) g/mol, (3.61±1.10) mg/L] of the adversepregnancy outcome group were higher than those [(28.77±6.95) g/mol,(2.24±0.87) mg/L] of the control group (P=0.01, P<0.01). The 24 hmean systolic blood pressure (SBP), 24 h mean diastolic blood pressure (DBP), 24 h systolic blood pressure variability and 24 h diastolicblood pressure variability [(155.8±8.4) mmHg, (102.1±5.1) mmHg, (0.13±0.05), and(0.12±0.04), respectively] were higher than those[(150.3±8.1) mmHg, (98.1±5.7) mmHg, (0.10±0.04) and (0.09±0.05), respectively] of the control group (P=0.002, P=0.001, P=0.002, P= 0.002, respectively). There were no significant differences in the history of antihypertensive drug use, pre-pregnancy BMI, and age be. tween adverse pregnancy outcome group and control group (P>0.05); and no differences were significant in urine protein quantitation, ce.sarean section rate, gestational weeks at the onset of disease and the gestational weeks for termination of pregnancy between adversepregnancy outcome group and control group (P>0.05). Logistic regression analysis results showed that the increased values of ACR, D-D,24 h SBP, 24 h DBP, 24 h SBPV, 24 h DBPV, and 24 h urinary protein level increased the risk of adverse pregnancy outcomes in womenwith pregnancy-induced hypertension (P<0.05).Conclusions The pregnancy outcome of women with hypertension during pregnancy is affected by a variety of factors. Increased ACR and plasma D-D levels are risk factors for adverse pregnancy outcomes. |
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