孕期PAPP-A、NEFA及AGT水平与妊娠期高血压的关系

Relationship between pregnancy-associated plasma protein-A,non-esterified fatty acids and angiotensin levels and gestational hypertension

目的分析孕期妊娠相关血浆蛋白-A(PAPP-A)、非酯化脂肪酸(NEFA)及血管紧张素(AGT)水平与妊娠期高血压的关系。方法选取沧州市人民医院产科2021年12月至2022年12月期间收治的98例妊娠期高血压患者作为观察组,根据病情严重程度分为轻度组、中度组、重度组;另选取同期同一医院产检正常的50例孕妇作为对照组。检测两组妊娠12~14周血清PAPP-A、NEFA及AGT水平,比较观察组与对照组、观察组不同亚组血清PAPP-A、NEFA及AGT水平,采用Pearson相关性分析血清PAPP-A、NEFA及AGT水平之间的相关性,采用Logistic回归分析妊娠期高血压患者发生不良妊娠结局的独立因素。结果观察组血清PAPP-A、NEFA及AGT水平均高于对照组(P<0.05);轻度组、中度组、重度组血清PAPP-A、NEFA及AGT水平均依次升高(P<0.05)。妊娠结局不良组不良孕产史、高血压家族史比例及血清PAPP-A、NEFA、AGT水平均高于正常组(P<0.05)。Pearson相关性分析显示,妊娠期高血压患者血清PAPP-A、NEFA及AGT水平之间呈正相关(P<0.05);Logistic多因素回归分析显示,不良孕产史及血清PAPP-A、NEFA、AGT水平是妊娠期高血压发生不良妊娠结局的独立危险因素(P<0.05)。结论孕期血清PAPP-A、NEFA及AGT水平与妊娠期高血压的发生及病情程度密切相关,且为不良妊娠结局的危险因素。

Objective To analyze the relationship of levels of pregnancy-associated plasma protein-A(PAPP-A),non-esterified fatty acids(NEFA)and angiotensin(AGT)with gestational hypertension.Methods A total of 98 patients with gestational hypertension who were treated in the Obstetrics Department of Cangzhou City People′s Hospital from December 2021 to December 2022 were selected as the observation group and were divided into mild,moderate,and severe groups according to the severity of the condition.Another 50 pregnant women with normal prenatal check-ups at the same hospital during the same period were selected as the control group.The serum levels of PAPP-A,NEFA,and AGT were measured at 12-14 weeks of pregnancy in both groups.The serum levels of PAPP-A,NEFA,and AGT were compared between the observation and control groups and among different subgroups within the observation group.Pearson correlation analysis was used to examine the correlations between serum levels of PAPP-A,NEFA,and AGT.Logistic regression analysis was used to identify the independent factors related to adverse pregnancy outcomes in patients with gestational hypertension.Results The levels of serum PAPP-A,NEFA and AGT in observation group were higher than those in control group(P<0.05).Serum PAPP-A,NEFA and AGT levels in mild group,moderate group and severe group were increased successively(P<0.05).The group with adverse pregnancy outcomes had higher proportions of adverse obstetric history and family history of hypertension,as well as higher serum levels of PAPP-A,NEFA,and AGT compared to the normal group(P<0.05).Pearson correlation analysis showed that there was a positive correlation among serum PAPP-A,NEFA and AGT levels in patients with gestational hypertension(P<0.05).Logistic multivariate regression analysis revealed that a history of adverse obstetric outcomes and serum levels of PAPP-A,NEFA,and AGT were independent risk factors for adverse pregnancy outcomes in gestational hypertension(P<0.05).Conclusions Serum levels of PAPP-A,NEFA and AGT during pregnancy are closely related to the occurrence and severity of gestational hypertension,and are risk factors for adverse pregnancy outcomes.