和肽素在妊娠期高血压疾病性心脏病患者的表达

Clinical significance of Copeptin in detection of hypertensive heart disease complicating pregnancy

目的研究和肽素(Copeptin)在妊娠期高血压疾病性心脏病检测的临床意义。方法选择2014-5至2018-11本院收治的110例妊娠期高血压疾病性心脏病患者为观察组,200例妊娠高血压疾病患者为妊高症组,60名健康孕妇为对照组。入院后测定Copeptin、NT-proBNP、左心室射血分数(LVEF)水平以及6分钟步行距离(6-MWT)。结果与对照组、妊高症组比较,观察组NT-proBNP、Copeptin升高、6-MWT、LVEF水平下降,组间比较有显著统计学意义(P<0.05)。对照组与妊高症组比较,组间无统计学意义(P>0.05)。观察组心功能Ⅱ、Ⅲ、Ⅳ级患者相比较,NT-proBNP、Copeptin升高、6-MWT、LVEF水平下降,组间比较有显著统计学意义(P<0.05)。以心功能Ⅳ级患者变化最为显著。相关性分析显示Copeptin、NT-proBNP水平与心功能呈正相关(r=0.749,P<0.01;r=0.681,P<0.01)。妊娠期高血压疾病性心脏病患者心功能受损越重,NT-proBNP、Copeptin水平越高。结论Copeptin可评估妊娠期高血压疾病性心脏病患者心功能损害程度,在判断病情及预后评价有较高的临床价值。

Objective To study the clinical significance of Copeptin in hypertensive disorder complicating pregnancy heart disease.Methods 110cases of hypertensive heart disease complicating pregnancy were selected from 2014-5to 2018-11,200patients with pregnancy-induced hypertension were selected as PIH group and 60healthy pregnant women as control group.Left ventricular ejection fraction(LVEF)and 6minute walking distance(6-MWT)of Copeptin,NTproBNP,were measured after admission.Results Compared with the control group and the PIH group,the level of 6-MWT-LVEF in the observation group was significantly higher than that in the control group(P<0.05).There was no significant difference between control group and PIH group(P>0.05).Compared with the patients of gradeⅡ,ⅢandⅣof cardiac function,the level of 6-MWT-LVEF increased and the level of 6-MWT-LVEF decreased in the observation group,and there was significant difference between the two groups(P<0.05).The changes of cardiac function gradeⅣwere the most significant.Correlation analysis showed that the level of Copeptin,NT-proBNP was positively correlated with cardiac function(r=0.749,P<0.01;r=0.681,P<0.01).The more serious the heart function impairment,the higher the NT-proBNP,Copeptin level in hypertensive disorder complicating pregnancy heart disease.Conclusion sST2,NT-proBNP can be used to evaluate the degree of cardiac dysfunction in hypertensive disorder complicating pregnancy,especially in patients with cardiac complications.