随诊间血压变异性与妊娠期高血压孕妇肾功能的关系研究

Relationship between Blood Pressure Variability and Renal Function in Pregnant Women with Gestational Hypertension

目的评估随诊间血压变异性与妊娠期高血压孕妇肾功能的关系。方法回顾性分析2019年1月—2021年12月莆田学院附属医院进行产前检查及分娩的单胎妊娠、无严重疾病2448例孕妇的基线信息和肾功能指标。按舒张压随诊间变异系数的第一、三四分位数将研究对象分为低变异组(n=2207)、中变异组(n=163)、高变异组(n=78),分析舒张压随诊间变异性与基线信息和肾功能的关系。结果201名研究对象最终确诊为妊娠期高血压,命名为妊娠期高血压组;其他2247名研究对象命名为健康对照组;妊娠期高血压组孕妇舒张压随诊间变异系数高于健康对照组,差异有统计学意义(P<0.05)。研究对象舒张压、妊娠期高血压/子痫前期病史、肾功能指标与舒张压随诊间变异系数存在线性相关性。此外,舒张压变异性与血清同型半胱氨酸(r=0.16)、肌酐(r=0.14)呈正相关,与估算肾小球滤过率呈负相关(r=-0.26),差异有统计学意义(P<0.05)。结论妊娠期高血压患者舒张压变异性增高,与肾功能改变具有一定相关性。

Objective To evaluate the relationship between blood pressure variability and renal function in pregnant women with gestational hypertension.Methods The baseline information and renal function indicators of 2448 preg⁃nant women with single pregnancy and no serious diseases who underwent prenatal examination and delivery in the Af⁃filiated Hospital of Putian University from January 2019 to December 2021 were retrospectively analyzed.The sub⁃jects were divided into low vanontion group(n=2207),medium vanontion group(n=163)and high vanontion group(n=78)according to the first,fourth and third quantiles of variation coefficient of diastolic blood pressure during followup.The relationship between diastolic blood pressure variation and baseline information and renal function was ana⁃lyzed.Results 201 subjects were eventually diagnosed with gestational hypertension and named as gestational hyper⁃tension group.The other 2247 subjects were named healthy control group.The coefficient of variation between followup visits of diastolic blood pressure in pregnant women with gestational hypertension group was higher than that in healthy control group,and the difference was statistically significant(P<0.05).There was a linear correlation between diastolic blood pressure,gestational hypertension/preeclampsia history,renal function index and the coefficient of variation between diastolic blood pressure follow-up.In addition,diastolic blood pressure variability was positively correlated with serum homocysteine(r=0.16)and creatinine(r=0.14),and negatively correlated with estimated glomeru⁃lar filtration rate(r=-0.26),the difference was statistically significant(P<0.05).Conclusion The variation of diastolic blood pressure in hypertensive patients during pregnancy is correlated with the change of renal function.