摘要
目的探讨早发型子痫前期孕妇出现不良妊娠结局与血清胱抑素C水平的相关性,以便更好地预测及减少不良妊娠结局的发生。方法选取2011年3月-2014年3月就诊于该科的早发型子痫前期孕妇127例,其中轻度组36例,重度组91例;另选择同期健康孕妇150例作为对照组。测定并比较两组子痫前期患者的一般指标,包括孕周、收缩压（SBP）、舒张压（DBP）、体重指数（BMI）、肌酐（Cr）、血尿素氮（BUN）、血尿酸（UA）、24 h尿蛋白定量等。测定健康孕妇孕中期及孕晚期的血清胱抑素C水平,同时测定轻度组及重度组胱抑素C水平,并与对照组进行比较。分析并比较子痫前期两组孕妇的妊娠结局,并分析子痫前期重度组不良妊娠结局的相关因素。结果重度组SBP、DBP、Cr、UA及24 h尿蛋白定量值均显著高于轻度组,差异有统计学意义（P〈0.05）。而年龄、分娩孕周、BMI及BUN在两组间相比,差异无统计学意义（P〉0.05）。同期健康孕妇妊娠中期血清胱抑素C水平为（0.89±0.12）mmol/L,妊娠后期为（1.03±0.20）mmol/L。子痫前期早发轻度组及重度组的血清胱抑素C水平分别为（1.21±0.41）mmol/L和（1.72±0.68）mmol/L,与对照组相比明显升高,差异有统计学意义（P〈0.05）。轻度组子痫前期孕妇羊水过少、胎儿生长受限、胎死宫内、胎盘早剥、低蛋白血症及HELLP综合征发生率均显著低于重度组,新生儿出生体重显著高于重度组,差异有统计学意义（P〈0.05）;而胎儿窒息、心力衰竭、脐血流比值升高及子痫发生率与重度组相比,差异无统计学意义（P〉0.05）。不良妊娠结局的发生与孕妇胱抑素C水平、Cr、UA及分娩孕周相关。结论子痫前期孕妇血清胱抑素C水平明显升高,且其水平与子痫前期程度呈正相关;重度子痫前期孕妇更容易并发不良妊娠结局;不良妊娠结局的发生与血清胱抑素C水平、Cr、UA及分娩孕周相关。
Objective To investigate the correlation between occurrence of adverse pregnancy outcomes and the level of serum cystatin C in pregnant women with early- onset preeclampsia,in order to better predict and reduce the incidence of adverse pregnancy outcomes. Methods A total of 127 pregnant women with early- onset preeclampsia who were admitted in the hospital from March 2011 to March 2014 were collected,including 36 cases in mild group and 91 cases in severe group. A group of 150 healthy pregnant women were selected as control group during the same period. General indicators were determined and compared between mild group and severe group,including gestational week,systolic blood pressure（ SBP）,diastolic blood pressure（ DBP）,body mass index（ BMI）,creatinine（ Cr）,blood urea nitrogen（ BUN）,uric acid（ UA）,24- hour urinary protein excretion,et al. The levels of serum cystatin C during the second and the third trimesters of pregnancy were determined in healthy pregnant women,mild group,and severe group,and then the results were compared with control group. The pregnancy outcomes were analyzed and compared between mild group and severe group. Related factors of adverse pregnancy outcomes in severe group were analyzed. Results In severe group,SBP,DBP,Cr,UA,and 24- hour urinary protein value were higher than those in mild group,and the difference was significant（ P 〈0. 05）. Age,gestational week,BMI,and BUN in these two groups had no significant difference（ P 〉0. 05）. For healthy pregnant women,the value of serum cystatin C during the second and the third trimesters of pregnancy were respectively（ 0. 89 ± 0. 12） mmol / L and（ 1. 03 ± 0. 20） mmol / L. The values of cystatin C in mild group and severe group were respectively（ 1. 21 ± 0. 41） mmol / L and（ 1. 72 ± 0. 68） mmol / L,which both were higher than those in control group with significant difference（ P 〈0. 05）. In mild group,the incidence rates of oligoamnios,fetal growth restriction,fetal death,placental abruption,hypoproteinemia,and HELLP syndrome were all significantly lower than those in severe group,and neonatal birth weight was higher with significant difference（ P 〈0. 05）. In mild group,fetal asphyxia rate,heart failure rate,umbilical blood flow ratio and incidence of preeclampsia had no significant difference compared with those in severe group（ P 〈0. 05）. The occurrence of adverse pregnancy outcomes had relationship with CC,Cr,UA,and gestational weeks in pregnant women. Conclusion Levels of serum CC significantly increases in early- onset preeclampsia patients. And CC level is positively correlated with severity of preeclampsia. Severe preeclampsia in pregnant women is more likely to be complicated with adverse pregnancy outcomes. CC,Cr,UA,and gestational weeks are related to adverse pregnancy outcomes.
出处
《中国妇幼保健》
CAS
2015年第26期4446-4448,共3页
Maternal and Child Health Care of China
