血清钙、PGI2、AngⅡ在妊娠高血压眼底病变预测及病情评估中的应用评价

Evaluation of serum calcium,PGI2,AngⅡin predicting ocular fundus lesions and evaluating the condition of hypertension in pregnancy

目的探讨血清钙、前列环素(PGI2)、血管紧张素Ⅱ(AngⅡ)在妊娠高血压(HDCP)眼底病变预测及病情评估中的应用价值。方法选取2018年7月至2019年10月华润武钢总医院收治的150例HDCP患者,根据分娩前是否发生眼底病变分为发生组(62例)、未发生组(88例),比较两组一般资料、入院时和分娩前血清钙、PGI2、AngⅡ水平,采用受试者操作特征(ROC)曲线及ROC曲线下面积(AUC)分析入院时血清钙、PGI2、AngⅡ预测HDCP眼底病变价值,并比较不同眼底分期、OCT表现患者血清钙、PGI2、AngⅡ水平,应用Spearman分析血清钙、PGI2、AngⅡ与眼底分期关系。结果发生组入院时、分娩前血清钙、PGI2低于未发生组,AngⅡ高于未发生组(P<0.05);血清钙、PGI2联合AngⅡ预测HDCP眼底病变的AUC较任一单一指标增大;随着眼底分期递增,血清钙、PGI2逐渐降低,AngⅡ逐渐升高(P<0.05);OCT异常者血清钙、PGI2低于正常者,AngⅡ高于正常者(P<0.05);血清钙、PGI2与眼底分期呈负相关,AngⅡ与眼底分期呈正相关(P<0.001)。结论血清钙、PGI2、AngⅡ与HDCP眼底病变及病情严重程度有关,联合检测可作为预测眼底病变与评估病情的一个可靠方案,为临床精准干预提供参考。

Objective To explore the application value of serum calcium,prostacyclin(PGI2)and angiotensinⅡ(AngⅡ)in the prediction and evaluation of fundus lesions of hypertension in pregnancy(HDCP).Methods A total of 150HDCP patients admitted to our hospital from January 2020 to July 2021 were divided into an occurrence group(62 cases)and a non-occurrence group(88 cases)according to whether fundus lesions occurred before delivery.The general data of the two groups were compared.Serum calcium,PGI2,AngⅡlevels at admission and before delivery,the receiver operating characteristic curve(ROC)and area under ROC(AUC)were used to analyze the value of serum calcium,PGI2,AngⅡat admission to predict HDCP fundus lesions and compare the differences The levels of serum calcium,PGI2,AngⅡin patients with fundus staging and OTC manifestations were analyzed by Spearman to analyze the relationship between serum calcium,PGI2,AngⅡand fundus staging.Results Serum calcium and PGI2 in the occurrence group at admission and before delivery were lower than those in the non-occurring group,and AngⅡwas higher than that in the non-occurring group(P<0.05).With the increase of fundus stage,serum calcium and PGI2 gradually decreased,while AngⅡgradually increased(P<0.05).Serum calcium and PGI2 in patients with abnormal OCT were lower than normal,and AngⅡwas higher than normal(P<0.05).Serum calcium and PGI2 were negatively correlated with fundus staging,while AngⅡwas positively correlated with fundus staging(P<0.001).Conclusion Serum calcium,PGI2 and AngⅡare related to HDCP fundus lesions and the severity of the disease.Combined detection can be used as a reliable method for predicting fundus lesions and assessing the disease,providing a reference for clinical precise intervention.