抗心磷脂抗体与妊娠期高血压疾病严重程度和母婴结局的相关性

Correlation Analysis of Anticardiolipin Antibodies with Severity of Hypertensive Disorder Complicating Pregnancy and Outcomes of Maternal and Infant

【目的】探讨抗心磷脂抗体(ACA)与妊娠期高血压疾病(HDCP)严重程度和母婴结局的相关性。【方法】选取2017年1月至2018年10月在本院接受分娩的133例合并HDCP孕妇作为观察组,根据病情严重程度分为高血压组(n=56)和子痫前期组(n=77)。另外选取同期在本院分娩的正常孕妇50例作为对照组。比较各组ACA、血压、尿蛋白水平,母婴结局及早产、胎儿生长受限、胎盘早剥、围生儿死亡等情况;分析ACA(包括ACA-IgG、ACA-IgM及ACA-IgA)水平与血压、尿蛋白及母婴结局的相关性。【结果】子痫前期组、高血压组的ACA-IgG、ACA-IgM、舒张压、收缩压、尿蛋白水平均显著高于对照组(P均<0.05);子痫前期组的ACA-IgG、ACA-IgM、舒张压、收缩压、尿蛋白水平均显著高于高血压组(P均<0.05),但三组孕妇ACA-IgA比较差异无统计学意义(P>0.05)。子痫前期组早产、胎儿生长受限、胎盘早剥、围生儿死亡的发生率明显高于高血压组,且高血压组早产、胎儿生长受限、胎盘早剥、围生儿死亡的发生率明显高于对照组(P均<0.05)。ACA-IgG与收缩压、舒张压、早产呈正相关(r分别为0.317、0.453、0.521,P均<0.05);ACA-IgM与早产、胎盘早剥呈正相关(r分别为0.650、0.524,P均<0.05)。【结论】HDCP孕妇的血清ACA水平与其疾病严重程度及母婴结局密切相关,检测血清ACA水平对于预测母婴结局具有一定参考价值。

【Objective】To investigate the effects of anticardiolipin antibodies(ACA)on the severity of hypertensive disorder complicating pregnancy(HDCP)and outcomes in maternal and fetal.【Methods】A total of 133 pregnant women with gestational hypertension who received childbirth in our hospital from January to February 2018 were selected as the observation group.According to the severity of the disease,the patients were divided into the hypertension group(n=56)and the preeclampsia group(n=77).During the same period,50 normal pregnant women who gave birth in our hospital were enrolled in the control group.The levels of anticardiolipin antibodies(ACA),blood pressure,urine protein,maternal and infant outcomes premature delivery,fetal growth restriction,placental abruption,perinatal death were compared among groups.The relationship of anticardiolipin antibody levels(ACA-IgG,ACA-IgM and ACA-IgA)with blood pressure,urine protein,and maternal and fetal outcomes was analyzed.【Results】The ACA-IgG,ACA-IgM,diastolic blood pressure,systolic blood pressure and urine protein levels in the preeclampsia group and hypertension group were higher than those in the control group(P<0.05).The ACA-IgG,ACA-IgM,diastolic blood pressure,systolic blood pressure and urine protein levels in the preeclampsia group were higher than those in the hypertension group(P<0.05).There was no significant difference in ACA-IgA between the three groups(P>0.05).The incidence of premature delivery,fetal growth restriction,placental abruption,and perinatal death in the preeclampsia group was significantly higher than that in the hypertension group(P<0.05).The incidence of premature delivery,fetal growth restriction,placental abruption,and perinatal death in the hypertension group was significantly higher than that in the control group(P<0.05).ACA-IgG was positively correlated with systolic blood pressure,diastolic blood pressure and premature birth(r=0.317,0.453,0.521,P<0.05).ACA-IgM was positively correlated with premature delivery and placental abruption(r=0.650,0.524,P<0.05).【Conclusion】The serum ACA level of pregnant women with hypertensive disorder complicating pregnancy is closely related to the severity of the disease and outcomes of maternal and infant.The detection of serum ACA level has certain reference value for predicting the outcome of poor maternal and child.