妊娠期高血压疾病患者尿酸、肌酐水平变化与围产儿预后的关系

The Relationship Between the Changes of Uric Acid and Creatinine in the Patients with Hypertensive Disorder Complicating Pregnancy

目的探讨妊娠期高血压疾病患者尿酸及肌酐水平变化的意义及与围产儿预后的关系。方法选择2014年6月至2016年1月在我院妇产科住院的妊娠期高血压疾病患者和同期住院的正常孕妇各200例,分为疾病组(轻度58例,中度62例,重度80例)和正常组,比较正常、低、中、重度妊高征孕妇血清尿酸及肌酐的水平及预后情况,及不同尿酸水平对围产儿预后的影响。结果随着妊高征的病情加重,患者血清尿酸、肌酐水平均逐渐升高,差异均有统计学意义(P<0.05)。随着妊高征病情程度的加重,围产儿宫内发育迟缓、低出生体重儿、宫内死胎、早产的数目逐渐增多,差异有统计学意义(P<0.05)。重度妊高征患者无应激反应实验阴性早产儿数目显著高于其他组,差异有统计学意义(P<0.05)。随着尿酸水平升高,围产儿体重逐渐下降,早产儿比例增高,尿酸水平高于364μmol/L时早产儿、IUGR比例均显著升高,体重明显降低,差异有统计学意义(P<0.05)。结论妊高征孕妇血清尿酸、肌酐水平、围产儿预后不良高于正常孕妇,且随着病情加重而升高;尿酸水平与围产儿预后具有相关性,高尿酸水平导致围产儿预后不良发生率明显升高。

Objective To investigate the relationship between the changes of uric acid and creatinine levels in patients with hypertensive disorder complicating pregnancy and perinatal prognosis. Methods 200 cases of pregnancy induced hypertension and normal pregnant women in our hospital from June 2014 to January 2016 were selected. All subjects were divided into disease group （58 mild cases, 62 moderate cases and 80 severe cases） and normal group, normal, low, moderate and severe PIH serum uric acid and creatinine levels and prognosis, and effects of different levels of uric acid on perinatal outcome. Results The serum uric acid and creatinine levels of the patients increased gradually with the aggravation of hypertension, and the difference was statistically significant （P〈0.05）. With the increase of the severity of pregnancy, the number of premature babies born in uterine intrauterine, low birth weight, uterine stillbirth and preterm labor increased gradually, and the difference was statistically significant （P〈0.05）. The number of negative preterm infants was significantly higher in patients with severe hypertension than in other groups, and the difference was statistically significant（P〈0.05）. With elevated uric acid levels, gradually decline perinatal weight, higher proportion of premature infants, uric acid levels above 364 mu mol/L premature babies, the proportion of IUGR were significantly elevated, weight decrease, the difference was statistically significant （P〈0.05）. Conclusion PIH serum uric acid, creatinine levels and adverse perinatal outcome were higher than normal pregnant women, and increased with aggravation; uric acid is associated with perinatal prognosis, high uric acid levels lead to adverse perinatal outcome was significantly higher than that in normal pregnant women.