尿酸、尿蛋白及脐动脉血流相关参数与妊娠期高血压患者母婴预后的相关性

Correlation between uric acid,urinary protein,umbilical artery blood flow parameters and maternal and neonatal prognosis in patients with hypertensive disorder of pregnancy

目的探讨尿酸(UA)、尿蛋白(PRO)及脐动脉血流相关参数与妊娠期高血压(HDP)患者母婴预后的相关性。方法选取2019年7月至2021年6月于丽水市妇幼保健院产检分娩的102例HDP患者作为HDP组,根据母婴预后分为正常预后组(n=73)和不良预后组(n=29);另随机选取同期同一医院产检的102例健康妊娠女性作为健康对照(HC)组。比较两组母婴结局和UA、24h PRO水平及脐动脉血流搏动指数(PI)、阻力指数(RI)、收缩期与舒张期流速比(S/D);采用Logistic回归分析影响母婴预后的相关因素;采用受试者工作特征(ROC)曲线检测UA、24h PRO及脐动脉血流参数预测不良母婴预后的效能。结果HDP组不良母婴结局总发生率为28.43%,高于HC组的11.76%(P<0.05);HDP组UA、24h PRO和PI、RI、S/D高于HC组(P<0.05);Logistic回归分析显示,孕妇年龄和24h PRO、RI、S/D为影响不良母婴预后的相关因素(P<0.05);ROC曲线分析显示,UA、PRO水平和PI、RI、S/D预测不良母婴预后的曲线下面积(AUC)分别为0.758、0.731和0.852、0.798、0.897。结论HDP患者UA、PRO水平和脐动脉血流相关参数均明显升高,孕妇年龄和24h PRO、RI、S/D均为影响HDP患者不良母婴预后的相关因素。

Objective To explore the correlation between uric acid(UA),urinary protein(PRO),umbilical artery blood flow parameters and maternal and neonatal prognosis in patients with hypertensive disorder of pregnancy(HDP).Methods A total of 102 patients with HDP undergoing prenatal examinations and delivery in Lishui Maternal and Child Health Hospital between July 2019 and June 2021 were enrolled as HDP group.According to maternal and neonatal prognosis,they were divided into normal prognosis group(n=73)and poor prognosis group(n=29).A total of 102 healthy pregnant women during the same period were randomly enrolled as healthy control(HC)group.The maternal and neonatal outcomes,levels of UA and 24h PRO,and umbilical artery blood flow parameters[pulsatility index(PI),resistanceindex(RI),ratio of systolic to diastolic velocity(S/D)]were compared between the two groups.The influencing factors of maternal and neonatal prognosis were analyzed by Logistic regression analysis.The predictive efficiency of UA,PRO and umbilical artery flow parameters for adverse maternal and neonatal prognosis was detected by receiver operating characteristic characteristic(ROC)curves.Results The total incidence of adverse maternal and neonatal outcomes in HDP group was higher than that in HC group(28.43%vs.11.76%,P<0.05),UA,24h PRO,PI,RI and S/D were also higher than those in HC group(P<0.05).Logistic regression analysis showed that maternal age,24h PRO,RI and S/D were influencing factors of adverse maternal and neonatal prognosis(P<0.05).ROC curves analysis showed that area under the curve(AUC)values of UA,PRO,PI,RI and S/D for predicting adverse maternal and neonatal prognosis were 0.758,0.731,0.852,0.798 and 0.897,respectively.Conclusions UA,PRO and umbilical artery blood flow parameters are significantly increased in HDP patients.The maternal age,24h PRO,RI and S/D are influencing factors of adverse maternal and neonatal prognosis in HDP patients.