子痫前期孕妇尿白蛋白/肌酐比值及血清AT1-AA水平与疾病严重程度和预后的关系

Influence of albumin creatinine ratio and serum antiangiotensinⅡtype 1 receptor activating antibody level on disease severity and prognosis of pregnant women with preeclampsia

目的:探讨子痫前期孕妇尿白蛋白/肌酐比值(ACR)及血清抗血管紧张素Ⅱ1型受体自身抗体(AT1-AA)水平对疾病严重程度和围生儿预后的影响。方法:选择新郑市妇幼保健院2018年9月—2020年10月收治的150例子痫前期孕妇作为子痫前期组,并依据病情程度将其分为轻度组(66例)、中度组(50例)与重度组(34例);同期60例健康妊娠孕妇作为正常妊娠组。观察各组ACR和血清AT1-AA水平,分析其与围生儿预后的相关性,比较两项指标对围生儿预后单独或联合诊断的受试者工作特征曲线下面积(AUC)。结果:子痫前期组的ACR和血清AT1-AA水平较正常妊娠组高(P<0.05)。随着ACR和血清AT1-AA水平上升,子痫前期孕妇的病情逐渐加重,其水平,轻度组<较中度<重度组(P均<0.05)。ACR和血清AT1-AA水平与胎儿生长受限、胎儿窘迫、新生儿窒息、新生儿死亡的发生呈正相关(P<0.05),指标水平升高,围生儿预后变差。ACR和血清AT1-AA水平联合诊断下的AUC明显大于两指标单独诊断(P<0.05)。结论:ACR和血清AT1-AA水平可反映子痫前期孕妇的疾病严重程度,且能在一定程度上预测围生儿的预后,其联合检测的诊断效能较高,值得临床推广。

Objective:To investigate the influence of albumin creatinine ratio(ACR)and the level of serum antiangiotensin II type 1 receptor activating antibody(AT1-AA)on the disease severity and prognosis of pregnant women with preeclampsia.Methods:A total of 150 cases of pregnant women with preeclampsia admitted in Xinzheng Maternal and Child Health Hospital from Sep.2018 to Oct.2020 were selected as the preeclampsia group,and divided into mild group(66 cases),moderate group(50 cases)and severe group(34 cases)according to the disease severity.60 healthy pregnant women in the same period were selected as the normal pregnancy group.The ACR and serum AT1-AA level in each group were observed,of witch the correlation with perinatal infant prognosis was analyzed.And then the areas under receiver operating characteristic curve(AUC)of the two indicators were compared for perinatal prognosis in single or combined diagnosis.Results:The ACR and serum AT1-AA level were higher in preeclampsia group than in normal pregnancy group(P<0.05).With the ACR and serum AT1-AA level increasing,the patient's condition worsened gradually in a rank of mild group<moderate group<severe group(P<0.05).The ACR and serum AT1-AA level were positively correlated with the incidence of fetal growth restriction,fetal distress,neonatal asphyxia and neonatal death(P<0.05).The AUC was significantly greater diagnosed with combined ACR and serum AT1-AA level than that diagnosed with the two indexes alone.Conclusions:ACR and serum AT1-AA level may reflect the disease severity of pregnant women with preeclampsia,and can predict the prognosis of perinatal infants to some extent.The combined detection may improve the diagnostic efficiency,and is worthy of clinical promotion.