子痫前期孕妇NT-ProBNP水平与妊娠结局关系的初步探讨

Preliminary Exploration of the Relationship Between NT-ProBNP and Pregnancy Outcomes in Preeclampsia

目的:研究子痫前期孕妇血清中不同水平氨基末端B型脑钠肽前体(NT-ProBNP)与妊娠结局的关系,为判断病情的严重性提供依据。方法:选择2013年12月-2017年1月在武汉大学中南医院妇产科诊治的子痫前期孕妇共455例,根据病情的严重程度,分为轻度子痫前期278例,重度子痫前期177例。收集两组血浆中NTProBNP、肌酐、尿素氮、尿酸、蛋白尿情况和相关并发症发生例数等。比较在不同水平的NT-ProBNP下,母婴并发症的发生及孕妇肾功能的改变情况。结果:重度子痫前期组入院时收缩压、舒张压及血浆中NT-ProBNP水平均显著高于轻度子痫前期组(P<0.05),重度子痫前期发病孕周要早于轻度子痫前期组(P<0.05)。随着NT-ProBNP水平的升高,母婴并发症(子痫、HELLP综合征、合并腹水、早产儿、低体重儿)发生率逐渐上升(P<0.05)。并且随着NT-ProBNP的升高,肌酐、尿素氮、尿酸、尿蛋白均明显升高(P<0.05)。结论:血浆NT-ProBNP水平可以反映子痫前期孕妇病情的严重程度,预测母婴并发症的发生以及用于孕妇肾功能的评价。

Objective:To investigate the relationship between the level of N-terminal Pro-brain natriuretic peptide(NT-ProBNP)and pregnancy outcomes of preeclampsia and provide reliable evidence for determining the severity of preeclampsia.Methods:A total of 455 patients with preeclampsia were collected from the department of Obstetrics and Gynecology,Zhongnan Hospital of Wuhan University from December 2013 to January 2017.Among them,278 cases of mild and177 cases of severe preeclampsia were selected depending on the severity of disease.The NTProBNP,creatinine,urea nitrogen,and uric acid in serum of two groups were collected and the cases of severe complications were also counted.Then,pregnancy outcomes and renal function were analyzed according to different levels of NT-ProBNP.Results:The systolic and diastolic pressure,NT-ProBNP in severe preeclampsia group were significantly higher than those in the mild preeclampsia(P<0.05),and the gestational weeks of preeclampsia occurrence in the formerwere less than in the latter(P<0.05).With the rise of NT-proBNP level in plasma,the incidence rates of perinatal complications(eclampsia,HELLP Syndrome,ascites,premature infant,and low birth weight infant)gradually increased.Besides,the level of creatinine,urea nitrogen,uric acid,proteinuria also increased obviously with the increase level of NT-ProBNP(P<0.05).Conclusion:The level of NT-ProBNP in serum can reflect the severity of preeclampsia and predict the risk of perinatal complications,besides,it can be used to evaluate the renal function of pregnant women.