血清BNP水平与子痫前期疾病严重程度及预后相关性

Analysis of correlation between serum BNP level in pregnant women with preeclampsia and their severity and prognosis of preeclampsia

目的:分析孕妇血清氨基末端B型脑钠肽前体(BNP)水平与子痫前期疾病严重程度及预后的相关性。方法:选取2015年2月-2019年4月本院收治的子痫前期孕妇362例,按病情分为重度组(165例)与轻度组(197例),另选取100例正常孕晚期孕妇为对照组,比较各组血清BNP水平;按血清BNP水平将子痫前期孕妇分为低水平组、中水平组、高水平组,比较各组间母婴结局,分析血清BNP水平与疾病严重程度及预后相关性。结果:对照组、轻度组及重度组血清BNP水平依次递增(151.29±106.78pg/ml、316.83±121.74pg/ml、594.68±172.09pg/ml)(P<0.05)。Cochran Armitage趋势检验,血清BNP水平与子痫前期严重程度呈线性增加趋势(Z=2.918,P<0.05)。BNP高水平组子痫发生率高于中水平组及低水平组(8.8%、2.9%、2.0%),腹水发生率高水平组(30.8%)与中水平组(20.2%)均高于低水平组(5.1%),并发症总发生率高水平组(59.3%)、中水平组(37.6%)、低水平组(15.3%)依次降低(均P<0.05)。双变量相关分析,血清BNP水平与孕妇并发症总发生率正相关(r=0.806,P<0.05)。围生儿早产及并发症总发生率高水平组(58.2%、68.1%)与中水平组(49.7%、56.7%)均高于低水平组(32.7%、35.7%),Apgar评分(7.43±0.27分、7.51±0.45分)低于低水平组(7.64±0.31分),新生儿出生体质量高水平组、中水平组、低水平组依次增高(2.04±0.11kg、2.29±0.07kg、2.61±0.25kg)(P<0.05),相关分析血清BNP水平与围生儿出生体质量呈负相关(r=-0.751,P<0.05)。结论:血清BNP水平与子痫前期疾病严重程度及预后有一定相关性。

Objective: To analyze the correlation between serum B-type natriuretic peptide(BNP) level of pregnant women with preeclampsia and their severity and prognosis of preeclampsia. Methods: 362 pregnant women with preeclampsia were selected and were divided into group A(165 cases with severe preeclampsia) and group B(197 cases with mild preeclampsia) from February 2015 to April 2019. Another 100 normal pregnant women during the third trimester of pregnancy were selected in control group. Serum BNP levels of women were compared among these groups. In group A and B, the women were also divided into low-level group, middle-level group and high-level group according to serum BNP levels. The maternal and infant outcomes were compared among these groups. The correlation between serum BNP level of women with preeclampsia and their disease severity and prognosis was analyzed. Results: The level of serum BNP of women in the control group, groupB, and group A were 151.29 ± 106.78 pg/ml, 316.83 ± 121.74 pg/ml, and 594.68 ± 172.09 pg/ml, and there was significant different among the three groups(P<0.05). Cochran Armitage trend test showed that the serum BNP level increased linearly with the severity of preeclampsia(z = 2.918, P<0.05). The eclampsia incidence of women in the high-level group was 8.8%, which was significant higher than that(2.9%) of women in the middle-level group and that(2.0%) of women in the low-level group. The incidence of ascites of women in the high-level group and middle-level group were 30.8%and 20.2%,which was significant higher than that(5.1%)of women in the low-level group.The total incidence of complications of women in the high-level group was the highest(59.3%),that of women in the middle-level group was 37.6%,and that(15.3%)of women in the low-level group was the lowest(all P<0.05).Bivariate correlation analysis showed that serum BNP level was positively correlated with the total incidence of complications(r=0.806,P<0.05).The total incidence of preterm delivery and complications of women in high and middle level groups were 58.2% and 68.1%,which were significant higher than those(49.7%and 56.7%)of women in the middle-level group and those(32.7%and 35.7%)of women in the low-level group.The Apgar score of women in the high and middle-level group were 7.43±0.27 points and 7.51±0.45 points,which were significant lower than that(7.64±0.31 points)of women in the low-level group.The birth weight of newborn in the high,middle,and low-level group were 2.04±0.11 kg,2.29±0.07 kg,and 2.61±0.25 kg,respectively(P<0.05).The correlation analysis showed that serum BNP level was negatively correlated with birth weight(r=-0.751,P<0.05).Conclusion:Serum BNP level is correlated with the severity and prognosis of pregnant women with preeclampsia.