妊娠期高血压疾病孕妇血清尿酸、肌酐、尿素氮水平对围产儿预后的影响

Effects of Serum Uric Acid,Creatinine and Urea Nitrogen Levels on Perinatal Prognosis in Pregnant Women with Hypertension

目的:分析妊娠期高血压疾病孕妇血清尿酸、肌酐、尿素氮水平变化,并探讨不同血清尿酸水平对围产儿预后的影响。方法:选择2017年8月-2019年5月于本院分娩的妊娠期高血压疾病孕妇168例为研究组,抽选同期来本院体检的健康孕妇100例设为参照组。比较两组血清尿酸、肌酐、尿素氮水平,同时观察不同血清尿酸水平对围产儿结局的影响。结果:研究组的血清尿酸、肌酐、尿素氮水平均高于参照组,差异均有统计学意义(P<0.05)。妊娠期高血压组、子痫前期组、重度子痫前期组。三组血清尿酸、肌酐、尿素氮水平比较,差异均有统计学意义(P<0.05);重度子痫前期组血清尿酸、肌酐、尿素氮水平均高于妊娠期高血压组及子痫前期组,子痫前期组血清尿酸、肌酐、尿素氮水平均高于妊娠期高血压组,差异均有统计学意义(P<0.05)。尿酸值297.5~400.0μmol/L的孕妇胎儿呼吸窘迫、胎儿生长受限、新生儿窒息的发生率均高于尿酸值<297.5μmol/L孕妇;尿酸值>400.0μmol/L孕妇胎儿呼吸窘迫、胎儿生长受限、新生儿窒息、新生儿死亡的发生率均高于尿酸值<297.5μmol/L孕妇;尿酸值>400.0μmol/L孕妇新生儿死亡的发生率高于尿酸值297.5~400.0μmol/L孕妇,差异均有统计学意义(P<0.05)。结论:妊娠期高血压疾病孕妇血清尿酸、肌酐、尿素氮水平均高于正常孕妇,且相应指标水平会随病情加重而升高,孕妇血清尿酸越高,围产儿不良结局的发生率就越高,临床或可将其作为围产儿预后的观测指标。

Objective:To analyze the changes of serum uric acid,creatinine and urea nitrogen levels in pregnant women with hypertension during pregnancy,and to explore the influence of different serum uric acid levels on the prognosis of perinatal infants.Method:A total of 168 pregnant women with pregnancy induced hypertension who were delivered in our hospital from August 2017 to May 2019 were selected as the study group,100 healthy pregnant women who came to our hospital for physical examination in the same period were selected as the reference group.The levels of serum uric acid,creatinine and urea nitrogen were compared between the two groups,at the same time,the effects of different serum uric acid levels on perinatal outcome were observed.Result:Serum levels of uric acid,creatinine and urea nitrogen in the study group were higher than those of the control group,the differences were statistically significant(P<0.05).Gestational hypertension group,preeclampsia group and severe preeclampsia group of serum levels of uric acid,creatinine and urea nitrogen compared,the differences were statistically significant(P<0.05).Serum levels of uric acid,creatinine and urea nitrogen in the severe preeclampsia group were higher than those of gestational hypertension group and the preeclampsia group,serum levels of uric acid,creatinine and urea nitrogen in the preeclampsia group were higher than those of gestational hypertension group,the differences were statistically significant(P<0.05).The incidence of perinatal fetal distress,fetal growth restriction and neonatal asphyxia in pregnant women with uric acid value of 297.5-400.0μmol/L were higher than those in pregnant women with uric acid value<297.5μmol/L,the incidence of perinatal fetal distress,fetal growth restriction,neonatal asphyxia and neonatal death in pregnant women with uric acid value of>400.0μmol/L were higher than those in pregnant women with uric acid value<297.5μmol/L,the incidence of perinatal neonatal death in pregnant women with uric acid value of>400.0μmol/L was higher than that of pregnant women with uric acid value of 297.5-400.0μmol/L,the differences were statistically significant(P<0.05).Conclusion:Serum uric acid,creatinine and urea nitrogen levels of pregnant women with gestational hypertension are higher than those of normal pregnant women,and the corresponding index levels would increase with the aggravation of the disease.The higher the serum uric acid of pregnant women is,the higher the incidence of adverse outcomes of perinatal infants.It may be used as an observational index of perinatal prognosis in clinic.