NT-proBNP对子痫前期孕妇肾功能的评价

Evaluation of NT-proBNP on renal function of pregnant women with preeclampsia

目的探讨N-端脑利钠肽前体(NT-proBNP)对子痫前期孕妇肾功能的评价效果。方法选取诊治的重度子痫前期孕妇120例、轻度子痫前期孕妇120例、正常妊娠孕妇120例,于门诊第1天和终止妊娠前行NT-proBNP检测和肾功能指标(尿酸、血肌酐、尿素氮、24 h尿蛋白)检测。结果在门诊第1天、终止妊娠前轻度子痫前期孕妇NT-proBNP、血肌酐、尿素氮、24 h尿蛋白均明显高于正常妊娠孕妇,重度子痫前期孕妇均明显高于正常妊娠孕妇和轻度子痫前期孕妇。随着子痫前期的出现和加重,妊娠并发症(心功能不全、肝损害、肾损害、眼底改变、胎盘早剥)发生率逐渐增加;随着NT-proBNP水平升高,血肌酐、尿素氮、24 h尿蛋白均显著升高,妊娠并发症发生率均显著增加,差异均有统计学意义(P<0.05)。结论 NT-proBNP随子痫前期的加重而升高,能影响孕妇肾功能,增加妊娠并发症发生风险。NT-proBNP可用于评价子痫前期孕妇肾功能。

Objective To explore the evaluation effect of NT-proBNP on renal function of pregnant women with preeclampsia. Methods A total of 120 pregnant women with severe preeclampsia,120 pregnant women with mild preeclampsia,and 120 normal pregnant women were selected from Outpatient Department of the hospital,NT-proBNP and renal function indexes（ uric acid,blood creatinine,urea nitrogen,24-hour urinary protein） on the first day and before pregnancy were detected. Results On the first day and before pregnancy,NT-proBNP,blood creatinine,urea nitrogen,and 24-hour urinary protein levels in mild preeclampsia group were significantly higher than those in normal pregnancy group; NT-proBNP,blood creatinine,urea nitrogen,and 24-hour urinary protein levels in severe preeclampsia group were significantly higher than those in normal pregnancy group and mild preeclampsia group. The incidence rates of pregnancy complications（ heart failure,liver damage,kidney damage,fundus changes,placental abruption） gradually increased with the occurrence and aggravation of preeclampsia; blood creatinine,urea nitrogen,and 24- hour urinary protein levels increased significantly with the increase of NT-proBNP level,the incidence rates of pregnancy complications increased significantly,there were statistically significant differences（ P〈0.05）. Conclusion NT- proBNP level increases with aggravation of preeclampsia,which can affect renal function and increase risk of pregnancy complications. NT-proBNP can be used to evaluate renal function of pregnant women with preeclampsia.