妊娠期高血压疾病相关因素分析

Analysis on factors related to hypertensive disorder complicating pregnancy

目的探讨淋巴细胞/单核细胞数的比值(LMR)与妊娠期高血压疾病(HDCP)的相关性。方法选择2013年1月至2017年12月在该院产前检查或住院治疗诊断为HDCP的患者366例(病例组),选取同期在该院分娩的无并发症及合并症的孕产妇692例为对照组,收集两组对象与HDCP相关的产前检查常用指标及LMR、WBC、中性粒细胞百分比(NEUT%)3个炎症相关指标,将有差异的指标与HDCP进行相关性分析,并评估LMR与HDCP的相关性。结果病例组与对照组单核细胞数及孕期增加体质量比较,差异无统计学意义(P>0.05);两组对象的年龄、羊水指数(AFI)、尿蛋白、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆汁酸、肌酐、分娩时体质量指数(BMI)、血压、新生儿体质量、Apgar评分、WBC、NEUT%、LMR、淋巴细胞数比较,差异均有统计学意义(P<0.05)。二元Logistic回归结果显示尿蛋白、肌酐、血压、NEUT%、LMR与HDCP的发生存在一定的正相关关系(B>0,P<0.05)。多项Logistic回归结果显示血压、尿蛋白、NEUT%、LMR与HDCP严重程度相关(B>0,P<0.05)。结论HDCP患者LMR高于正常孕妇,且随着疾病的严重程度增加而增加。LMR高于3.95需警惕HDCP的发生。

Objective To study the correlation between lymphocytes/monocytes ratio(LMR)and hypertensive disorder complicating pregnancy(HDCP).Methods A total of 366 patients with prenatal examination or hospitalization diagnosed as HDCP in this hospital from January 2013 to December 2017 were selected as the case group and contemporaneous 692 pregnant parturients with delivery in this hospital without complications and concomitant diseases were selected as the control group.The HDCP related prenatal examination common indexes and 3 inflammation related indexes of LMR,WBC count,neutrophilic granulocyte percentage(NEUT%)were collected.The different indexes and HDCP conducted the correlation analysis.The correlation between LMR and HDCP was evaluated.Results The monocytes number and increased BMI during pregnancy had no statistical difference between the case group and control group(P>0.05);the age,amniotic fluid index(AFI),urine protein,ALT,AST,total bile acid,creatinine,BMI at delivery,blood pressure,new born body mass,Apgar score,WBC count,NEUT%,LMR and lymphocytes had statistical differences between the two groups(P<0.05).The binary Logistic regression results showed that urine protein,creatinine,blood pressure,NEUT%and LMR had a certain positive correlation with the HDCP occurrence(B>0,P<0.05).The multiterm Logistic regression results showed that blood pressure,urine protein,NEUT%and LMR were correlated with the HDCP severity(B>0,P<0.05).Conclusion LMR in HDCP patients is higher than that in the normal pregnant women,moreover the LMR value is increased with the disease severity increase.LMR higher than 3.95 needs to be alert to the HDCP occurrence.