妊娠期高血压疾病患者血清尿酸水平对母婴预后的影响

Effect of Serum Uric Acid Level on Maternal and Infant Prognosis in Patients with Hypertensive Disorder Complicating Pregnancy

目的探讨妊娠期高血压疾病患者血清尿酸水平对母婴预后的影响。方法选取2014年7月—2017年6月该院妇产科住院分娩产妇3 086例,妊娠期高血压疾病产妇193例作为研究组,其中妊娠期高血压89例,子痫前期-子痫78例,妊娠合并慢性高血压15例,慢性高血压并发子痫前期11例。并选择同期住院分娩的正常产妇193名作为对照组,使其在分娩年龄、分娩孕周、孕前体质指数方面成组匹配。收集研究组和对照组的血液标本,用尿酸酶-过氧化物酶偶联/终点法检测尿酸水平,比较各组间母婴预后的差别。结果妊娠期高血压疾病患病率为6.25%;与对照组(269.36±49.71)μmol/L比较,子痫前期-子痫组(373.84±83.25)μmol/L、慢性高血压并发子痫前期组(416.53±88.84)μmol/L和妊娠合并慢性高血压组(312.75±61.48)μmol/L孕妇尿酸水平显著升高(P<0.05);对照组:新生儿窒息(1.04%)、低体重儿(1.55%)、产后出血(1.04%),子痫前期-子痫组、慢性高血压并发子痫前期组和妊娠合并慢性高血压组:新生儿窒息分别为(5.19%、18.75%、9.09%)、低体重儿分别为(14.29%、37.50%、18.18%)、产后出血分别为(10.39%、12.50%、9.09%),与对照组比较,研究组并发症发生率明显增加(P<0.05);剖宫产率:对照组为(30.05%),妊娠期高血压组、子痫前期-子痫组、妊娠合并慢性高血压组和慢性高血压并发子痫前期组分别为53.93%、93.51%、100%、72.73%,与对照组比较,研究组剖宫产率明显增加(P<0.01)。结论妊娠期高血压疾病患者血清尿酸升高会对母婴预后产生不利影响。

Objective To investigate the effect of serum uric acid level on maternal and infant prognosis in patients with hypertensive disorder complicating pregnancy. Methods 3086 cases of pregnant women in our hospital from July2014 to June 2017 were selected.193 cases of delivery women with gestational hypertension were selected as the research group, including 89 cases with gestational hypertension group, 78 cases with preeclampsia – eclampsia group,15 cases with pregnancy and chronic hypertension, 11 cases with chronic hypertension complicated with preeclampsia group, 193 cases of at the same period normal pregnant woman were selected as the control group. The study group and the control group were matched at the pregnancy age,gestational week,BMI,gravidity,parity, and the blood samples of the study group and the control group of patients were collected, and uric acid enzyme-peroxidase coupling/endpoint method was used to detect uric acid level, and the difference of the maternal and infant prognosis between the groups was compared. Results The rate of hypertensive disorder complicating pregnancy was 6.25%. Compared with that in the control group（ 269.36±49.71）μmol/L, the uric acid level of the preeclampsia – eclampsia group（373.84±83.25）μmol/L,chronic hypertension and preeclampsia group（416.53 ±88.84）μmol/L and pregnancy and chronic hypertension group（312.75 ±61.48）μmol/L significantly increased（P 〈0.05）. Control group： neonatal asphyxia（1.04%）,low birth weight（1.55%）, postpartum hemorrhage（1.04%）, the preeclampsia – eclampsia group, chronic hypertension and preeclampsia group and pregnancy and chronic hypertension group： neonatal asphyxia respectively was（5.19%, 18.75%, 9.09%）, low birth weight infants respectively was（14.29%, 37.50%,18.18%）, postpartum hemorrhage respectively was（10.39%, 12.50%, 9.09%）, compared with that in the control group, complications in study group increased significantly（P〈 0.05）. The rate of cesarean section： the control group（30.05%）, gestational hypertension, preeclampsia-eclampsia group, chronic hypertension and preeclampsia group and chronic hypertension complicating pregnancy group respectively was 53.93%, 93.51%, 100%, 72.73%, compared with the control group, the cesarean section rate in the study group was significantly increased（P 〈0.01）. Conclusion The increase of serum uric acid in patients with hypertensive disorder complicating pregnancy will have an adverse effect on the prognosis of maternal and neonatal.