血尿酸与妊娠合并慢性高血压严重程度的关系及其对子痫前期的预测研究

The relationship between serum uric acid and the severity of pregnancy complicated with chronic hypertension and its prediction for preeclampsia

目的分析血尿酸与妊娠合并慢性高血压严重程度的关系及其对子痫前期的预测价值。方法选取2018年1月至2020年8月昆山市第一人民医院诊治的146例妊娠合并慢性高血压孕妇作为研究对象。根据血尿酸水平将其分为高尿酸血症组(n=98)和非高尿酸血症组(n=48),比较两组慢性高血压分级,使用Pearson相关性分析血尿酸与收缩压、舒张压的关系,通过受试者工作特征曲线(ROC)下面积(AUC)评价血尿酸对子痫前期的预测效能。结果高尿酸血症组慢性高血压分级高于非高尿酸血症组,差异具有统计学意义(P<0.05);经Pearson相关性分析,妊娠合并慢性高血压孕妇血尿酸水平与收缩压、舒张压均呈正相关(P<0.05);经单因素分析和多因素Logistic回归分析,年龄、孕前体重指数(BMI)和血尿酸均是妊娠合并慢性高血压孕妇并发子痫前期的独立预测因素(P<0.05);经ROC分析,血尿酸预测妊娠合并慢性高血压孕妇并发子痫前期的AUC为0.912。结论血尿酸与妊娠合并慢性高血压严重程度呈正相关,预测子痫前期发生的效能较好,对该病治疗方案的制定具有指导意义。

Objective To analyze the relationship between serum uric acid and the severity of pregnancy complicated with chronic hypertension and its predictive value for preeclampsia.Methods 146 pregnant women with chronic hypertension who were admitted to the First People's Hospital of Kunshan City from January 2018 to August 2020 were selected and divided into hyperuricemia group(n=98)and non-hyperuricemia group(n=48)according to serum uric acid levels.The classification of chronic hypertension of the two groups were compared,and the relationship between serum uric acid and systolic and diastolic blood pressure was analyzed by Pearson correlation.The predictive effect of serum uric acid on preeclampsia was evaluated by the area under receiver operating characteristic curve(ROC).Results The grade of chronic hypertension in hyperuricemia group was higher than that in non-hyperuricemia group(P<0.05).Pearson correlation analysis showed that serum uric acid level of pregnant women with chronic hypertension was positively correlated with systolic blood pressure and diastolic blood pressure(P<0.05).Univariate analysis and multivariate Logistic regression analysis showed that age,pre-pregnancy body mass index(BMI)and serum uric acid were independent predictors of preeclampsia in pregnant women with chronic hypertension(P<0.05).ROC curve analysis showed that the AUC of serum uric acid in predicting preeclampsia in pregnant women complicated with chronic hypertension was 0.912.Conclusions Serum uric acid was positively correlated with the severity of pregnancy complicated with chronic hypertension,and the efficacy of predicting the occurrence of preeclampsia was good,which had guiding significance for the formulation of treatment plan of this disease.