血尿素氮水平与子痫前期并发胎儿生长受限的关系及其诊断价值

Relationship of blood urea nitrogen level with concomitant fetal growth restriction in preeclampsia and its diagnostic value

目的探讨血尿素氮水平与子痫前期并发胎儿生长受限(FGR)的关系及其诊断价值。方法回顾性分析381例子痫前期孕妇[并发FGR 167例(FGR组),未并发FGR 214例(非FGR组)]的一般临床资料和肾功能指标。比较两组患者上述指标的差异。采用多因素Logistic回归模型分析血尿素氮水平与子痫前期并发FGR的关系,采用受试者工作特征(ROC)曲线分析血尿素氮水平对子痫前期并发FGR的辅助诊断价值。结果多因素Logistic回归分析结果显示,血尿素氮水平升高是子痫前期患者并发FGR的独立危险因素,调整相关变量后,血尿素氮水平升高仍为子痫前期患者并发FGR的危险因素(均P<0.05)。在年龄<35岁的子痫前期患者中,血尿素氮水平诊断FGR的ROC曲线下面积为0.623(P<0.05),特异度为50.4%,敏感度为75.5%;在年龄为35~<40岁的子痫前期患者中,血尿素氮水平诊断FGR的ROC曲线下面积为0.729(P<0.05),特异度为79.6%,敏感度为57.5%;在年龄≥40岁的子痫前期患者中,血尿素氮水平诊断FGR的ROC曲线下面积为0.602(P>0.05)。结论血尿素氮水平升高是子痫前期并发FGR的独立危险因素,其对年龄为35~<40岁子痫前期患者并发FGR的诊断效果较好。

Objective To investigate the relationship of the blood urea nitrogen level with concomitant fetal growth restriction(FGR)in preeclampsia and its diagnostic value.Methods The general clinical data and renal function indices were retrospectively analyzed among 381 pregnant women with preeclampsia(including 167 cases with concomitant FGR[FGR group]and 214 cases without concomitant FGR[non-FGR group]).The aforementioned indices were compared between the two groups.The multivariate Logistic regression model was used to analyze the relationship of the blood urea nitrogen level with concomitant FGR in preeclampsia.Receiver operating characteristic(ROC)curve was employed to analyze the value of the blood urea nitrogen level for the auxiliary diagnosis of concomitant FGR in preeclampsia.Results The results of multivariate Logistic regression analysis revealed that an elevated level of blood urea nitrogen was an independent risk factor for concomitant FGR in preeclampsia patients;after adjusting the related variables,an elevated level of blood urea nitrogen was still a risk factor for concomitant FGR in preeclampsia patients(all P<0.05).Among preeclampsia patients younger than 35 years,the blood urea nitrogen level yielded an area under the ROC curve of 0.623(P<0.05),a specificity of 50.4% and a sensitivity of 75.5% for diagnosing FGR.Among preeclampsia patients aged 35 to<40 years,the blood urea nitrogen level exhibited an area under the ROC curve of 0.729(P<0.05),a specificity of 79.6% and a sensitivity of 57.5% for diagnosing FGR.The blood urea nitrogen level yielded an area under the ROC curve of 0.602 for diagnosing FGR in preeclampsia patients aged 40 years or above(P>0.05).Conclusion The elevated level of blood urea nitrogen is an independent risk factor for concomitant FGR in preeclampsia,and it has favorable diagnostic efficacy for concomitant FGR in preeclampsia patients aged 35 to<40 years.