BUN、Cr、UA、β2-MG变化及血清CK-MB、cTnI、NT-proBNP水平与慢性高血压并发重度先兆子痫的相关性分析

Correlation analysis of BUN,Cr,UA,β2-MG levels,serum CK-MB,cTnI,NT-probNP levels and chronic hypertension complicated with severe preeclampsia

目的:研究血清尿素氮(BUN)、肌酐(Cr)、尿酸(UA)、β2微球蛋白(β2-MG)水平变化及血清肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)水平、血清N-端脑利钠肽前体(NT-proBNP)与慢性高血压并发重度先兆子痫的相关性。方法:将360例慢性高血压孕妇纳入研究,按照是否并发重度先兆子痫分作A组(并发重度先兆子痫)89例及B组(未并发重度先兆子痫)271例。另择同期正常孕妇100例作为C组,100例单纯先兆子痫病人作为D组。比较4组基线资料,血清BUN、Cr、UA、β2-MG以及CK-MB、cTnI、NT-proBNP水平,并以多因素logistic回归分析明确慢性高血压病人并发重度先兆子痫与各项影响因素的关系。并比较4组孕妇及新生儿不良妊娠结局发生情况。结果:A组年龄均高于B组、C组、D组,且B组、D组年龄高于C组(P<0.05~P<0.01);A组、D组先兆子痫史占比均高于B组、C组(P<0.01);A组高血压病程高于B组,差异有统计学意义(P<0.01)。A组、B组、D组血清BUN、Cr、UA、β2-MG以及CK-MB、cTnI、NT-proBNP水平以及新生儿低出生体质量、宫内发育迟缓、胎儿窘迫、胎儿窒息、巨大儿、先天性异常及胎儿死亡发生率、孕妇不良妊娠结局总发生率均高于C组,且A组上述各项指标水平均高于B组和D组(P<0.05)。多因素logistic回归分析发现,孕妇年龄、先兆子痫病史、高血压病程以及血清BUN、Cr、UA、β2-MG以及CK-MB、cTnI、NT-proBNP水平均是慢性高血压病人并发重度先兆子痫的危险因素(P<0.05~P<0.01)。Pearson相关分析发现,血清BUN、Cr、UA、β2-MG以及CK-MB、cTnI、NT-proBNP水平均与慢性高血压并发重度先兆子痫呈正相关关系(P<0.01)。结论:检测血清BUN、Cr、UA、β2-MG及CK-MB、cTnI、NT-proBNP水平能有效预测重度先兆子痫的发生。

Objective:To study the correlation between the levels of blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),β2 microbulin(β2-MG)levels,serum creatine kinase isoenzyme(CK-MB),troponin I(cTnI),N-terminal brain natriuretic peptide precursor(NT-proBNP)levels and chronic hypertension complicated with severe preeclampsia.Methods:A total of 360 patients with chronic hypertension were included in the study.According to the complication of severe preeclampsia,89 cases were divided into group A(complication of severe preeclampsia)and 271 cases were divided into group B(non-complication of severe preeclampsia).In addition,100 normal pregnant women were selected as group C and 100 patients with preeclampsia were selected as group D.The baseline data of the four groups were compared,and the serum levels of BUN,Cr,UA,β2-MG,CK-MB,cTnI and NT-proBNP were compared.The relationship between severe preeclampsia in chronic hypertension patients and various influencing factors was determined by multivariate logistic regression analysis.In addition,adverse pregnancy outcomes in neonates and pregnant women in the four groups were compared.Results:The age of group A was higher than that of group B,group C,and group D,and the age of group B and group D was higher than that of group C(P<0.05 to P<0.01).The proportion of preeclampsia history in group A and group D was higher than that in group B and group C(P<0.01).The duration of hypertension in group A was higher than that in group B,and the difference was statistically significant(P<0.01).Serum BUN,Cr,UA,β2-MG,CK-MB,cTnI,and NT-proBNP,as well as the incidence of low birth weight,intrauterine growth retardation,fetal distress,fetal asphyxia,macrosomia,congenital abnormalities,and fetal death in newborns,the overall incidence of adverse pregnancy outcomes in pregnant women,were higher than those in group C,and the above indicators in group A were higher than those in group B and group D(P<0.05).Multivariate logistic regression analysis found that maternal age,history of preeclampsia,course of hypertension,and serum BUN,Cr,UAβ2-MG,CK-MB,cTnI,and NT-proBNP levels were risk factors for severe preeclampsia in patients with chronic hypertension(P<0.05 to P<0.01).Pearson correlation analysis found that serum BUN,Cr,UA,β2-MG,CK-MB,cTnI,and NT-proBNP were positively correlated with chronic hypertension complicated with severe preeclampsia(P<0.01).Conclusions:The occurrence of severe preeclampsia can be effectively predicted by detecting serum BUN,Cr,UA,β2-MG,CK-MB,cTnI and NT-proBNP levels in clinical work.