妊娠期高血压疾病患者血浆脑钠肽、胎儿纤维连接蛋白对微血管损伤及心功能影响

Effects of the plasma brain natriuretic peptide and the fetal fibronectin levels of the pregnant women with hypertensive disorder complicating pregnancy on their microvascular injury and cardiac function

目的:探讨脑钠肽(BNP)和胎儿纤维连接蛋白(FFN)对妊娠期高血压疾病孕妇微血管损伤及心功能的影响。方法:回顾性收集2016—2018年本院就诊的健康孕妇(对照组)和妊娠期高血压疾病患者,根据疾病严重程度分为妊娠高血压组、轻度子痫前期组和重度子痫前期组,对比各组BNP和FFN水平、微血管损伤指标、心功能指标以及相关性。结果:妊娠期高血压疾病3组BNP和FFN水平均高于对照组,且疾病越严重BNP和FFN水平越高(P<0.01)。对照组、妊娠高血压组、轻度子痫前期组和重度子痫前期组LVEF、E/A依次下降;与对照组相比,妊娠高血压组、轻度子痫前期组、重度子痫前期CO升高,而CI降低,且随血压升高CO值增加、CI值降低;妊娠高血压组、轻度子痫前期组、重度子痫前期组RFF低于对照组,NO、vWF和TM水平均高于对照组(均P<0.05)。BNP和FFN与LVEF、CI、E/A呈负相关,与CO、NO、vWF和TM呈正相关(均P<0.05)。结论:妊娠期高血压疾病孕妇BNP和FFN水平与微血管损伤及心功能有关且具有相关性,BNP、FFN水平越高微血管损伤越严重,心室舒张功能越差。

Objective:To investigate the effects of the brain natriuretic peptide(BNP)and the fetal fibronectin(FFN)levels of the pregnant women with hypertensive disorder complicating pregnancy on their microvascular injury and cardiac function.Methods:The healthy pregnant women(in control group)and the pregnant women with hypertensive disorder complicating pregnancy(in study group)from 2016 to 2018 were collected retrospectively.The women in the study group were divided into group A1(women with gestational hypertension),group A2(women with mild preeclampsia),and group A3(women with severe preeclampsia)according to different severity of hypertensive disorder complicating pregnancy.The BNP and FFN levels,the indexes of microvascular injury and cardiac function indexes of the women were compared among these groups.The correlation between the BNP and FFN levels of the women and their indexes of microvascular injury and cardiac function was analyzed.Results:The BNP and FFN levels of the women in the study group were significant higher than those of the women in the control group,and the BNP and FFN levels of the women in group A3 were the highest,while those of the women in A1 group were the lowest(P<0.01).The values of LVEF and E/A of the women in the control group,group A1,group A2,and group A3 had decreased in turn.The value of CO of the women in the control group,group A1,group A2,and group A3 had increased in turn.With the elevation of the blood pressure value of the women,their CO value increased,but their CI value decreased.The RFF value of the women in group A1,group A2,and group A3 were significant lower than that of the women in the control group,while the values of NO,vWF,and TM of the women were significant higher than those of the women in the control group(all P<0.05).Conclusion:The levels of BNP and FFN of the pregnant women with hypertensive disorder complicating pregnancy are related to their microvascular damage and cardiac function.The higher of the levels of BNP and FFN,the more serious the microvascular injury and the worse the ventricular diastolic function.