血清硫化氢与妊娠期高血压疾病严重程度及预后的相关性分析

Correlation analysis of serum hydrogen sulfide with severity and prognosis of hypertensive diseases during pregnancy

目的探讨血清硫化氢与妊娠期高血压疾病严重程度及预后的相关性。方法选取2018年1月~2020年1月收治的60例妊娠期高血压患者,依照其病情严重程度,将17例重度子痫前期患者分为重度组,将14例子痫前期患者分为中度组,将29例妊娠期高血压患者分为轻度组,对比三组患者血压与血清硫化氢表达水平,并分析血清硫化氢与妊娠期高血压疾病严重程度的相关性。通过随访,观察并记录60例妊娠期高血压患者产后新生儿情况,将新生儿Apgar评分<7分,羊水污染程度为Ⅲ度,胎儿胎心率超过180次/min分为预后不良组,共计11例,将剩余49例患者分为预后良好组,对比两组患者的临床特征,并分析血清硫化氢对妊娠期高血压预后的预测价值。结果三组患者舒张压、收缩压、硫化氢表达水平对比差异显著,重度组舒张压和收缩压明显高于中度组和轻度组,硫化氢明显低于中度组和轻度组(P<0.05);Spearman相关分析结果显示:妊娠期高血压疾病严重程度与舒张压、收缩压呈正相关(P<0.05),与硫化氢呈负相关(P<0.05);预后良好组与预后不良组患者年龄、妊娠次数、血红蛋白等临床特征对比无明显差异(P>0.05),两组患者产次、高血压家族史、妊娠前高血压史、硫化氢对比差异显著(P<0.05);logistic回归分析结果显示:产次、妊娠前高血压史、硫化氢水平降低是妊娠期高血压疾病的预后独立危险因素(P<0.05)。结论血清硫化氢与妊娠期高血压疾病的严重程度具有明显相关性,硫化氢表达水平越低,患者病情越严重。应用血清硫化氢水平能够预测妊娠期高血压疾病患者的预后情况,为患者的临床治疗与诊断提供参考。

Objective To investigate the correlation between serum hydrogen sulfide and the severity and prognosis of pregnancy induced hypertension syndrome.Methods From January 2018 to January 2020,60 patients with pregnancy induced hypertension syndrome in our hospital were selected as the research objects.According to the severity of the disease,17 patients with severe preeclampsia were divided into severe group,14 patients with preeclampsia were divided into moderate group,and 29 patients with pregnancy induced hypertension were divided into mild group,Blood pressure and serum hydrogen sulfide expression levels were compared among the three groups,and the correlation between serum hydrogen sulfide and the severity of pregnancy induced hypertension was analyzed.Through follow-up,observation and records of 60 patients with gestational hypertension syndrome postpartum and neonatal situation,the neonatal Apgar score<7 points,amniotic fluid pollution level Ⅲ,fetal heart rate of more than 180 times/min as poor prognosis group,a total of 11 cases,the remaining 49 patients were divided into good prognosis group,compared two groups of patients with clinical features,The predictive value of serum hydrogen sulfide on the prognosis of hypertensive syndrome during pregnancy was analyzed.Results There were differences in the expression levels of diastolic blood pressure,systolic blood pressure and hydrogen sulfide among the three groups.The diastolic blood pressure and systolic blood pressure of severe group were different in the moderate group and mild group,and hydrogen sulfide was different in the moderate group and mild group(P<0.05);Spearman correlation analysis showed that diastolic and systolic blood pressure were positively correlated with the severity of pregnancy induced hypertension syndrome(P<0.05),and hydrogen sulfide was negatively correlated with the severity of pregnancy induced hypertension syndrome(P<0.05);There was no difference in age,hemoglobin and other clinical characteristics between good prognosis group and poor prognosis group(P>0.05)There was no significant difference in age,number of pregnancies,hemoglobin and other clinical characteristics between the good prognosis group and the poor prognosis group(P>0.05).There were significant differences in the number of births,family history of hypertension,history of pre pregnancy hypertension and hydrogen sulfide between the two groups(P<0.05);Logistic regression analysis showed that time of birth,history of hypertension before pregnancy and decreased hydrogen sulfide level were independent risk factors for prognosis of hypertensive diseases during pregnancy(P<0.05).Conclusion Serum hydrogen sulfide is not only significantly correlated with the severity of hypertensive disease during pregnancy,but also the lower the expression level of hydrogen sulfide,the more severe the condition of patients.In addition,the application of serum hydrogen sulfide level can also predict the prognosis of hypertensive patients during pregnancy,providing reference for clinical treatment and diagnosis of patients.