|本期目录/Table of Contents|

[1]张林林,王文卿,吴元赭.肾功能指标水平变化与妊娠期高血压疾病的相关性[J].医学研究与战创伤救治(原医学研究生学报),2021,23(04):359-362.[doi:10.3969/j.issn.1672-271X.2021.04.005]
　ZHANG Lin-lin,WANG Wen-qing,WU Yuan-zhe.A study of the correlation between changes in renal function indexes and hypertensive disorder complicating pregnancy[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2021,23(04):359-362.[doi:10.3969/j.issn.1672-271X.2021.04.005]
点击复制

肾功能指标水平变化与妊娠期高血压疾病的相关性()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第23卷
期数:
2021年04期
页码:
359-362
栏目:
临床研究
出版日期:
2021-08-10

文章信息/Info

Title:
A study of the correlation between changes in renal function indexes and hypertensive disorder complicating pregnancy
作者:
张林林; 王文卿; 吴元赭
作者单位：210002南京，南京医科大学金陵临床医学院（东部战区总医院）妇产科（张林林、王文卿、吴元赭）
Author(s):
ZHANG Lin-lin;  WANG Wen-qing;  WU Yuan-zhe
(Department of Obstetrics and Gynecology,Jinling Hospital, Nanjing Medical University/General Hospital of Eastern Theater Command, PLA, Nanjing 210002, Jiangsu, China)
关键词:
妊娠期高血压疾病; 肌酐; 尿酸; 尿素氮; 重度子痫前期
Keywords:
hypertensive disorder complicating pregnancy; creatinine; uric acid; urea nitrogen; severe pre-eclampsia
分类号:
R714.25
DOI:
10.3969/j.issn.1672-271X.2021.04.005
文献标志码:
A
摘要:
目的观察妊娠期高血压疾病早期血清肌酐、尿素氮、尿酸等常见肾功能指标水平变化及与疾病严重程度的相关性。方法回顾性分析2017年1月至2019年12月在东部战区总医院建卡、规范化产检并分娩的妊娠期高血压疾病患者90例的临床资料，所有患者均在入院后确诊为妊娠期高血压疾病，并于入院后1～2周内分娩。其中妊娠期高血压患者34例（妊娠期高血压组），轻度子痫前期患者25例（轻度子痫前期组），重度子痫前期患者31例（重度子痫前期组），并随机同期选取正常妊娠孕妇50例（正常妊娠组）作为对照。收集4组产妇一般情况、分娩前2周血清肌酐、尿素氮、尿酸水平等临床资料，进行分析比较。结果①各组血清肌酐、尿素氮、尿酸水平比较，差异有统计学意义（P＜0.05）。②各组血清肌酐、尿素氮、尿酸水平变化与疾病严重程度呈正相关（正常妊娠组＜妊娠期高血压组＜轻度子痫前期组＜重度子痫前期组）；妊娠期高血压组血清肌酐、尿素氮、尿酸水平较正常妊娠组分别增高19.57%、11.40%、13.46%；轻度子痫前期组各指标分别增高30.99%、25.46%、31.42%；重度子痫前期组则分别增高50.87%、41.65%、57.62%。③血清尿酸升高是重度子痫前期发生的危险因素[OR（95%CI）: 1.013(1.007～1.018), P＜0.01]，ROC曲线表明，血清尿酸值327 μmol/L是重度子痫前期最佳预测值，敏感度0.806、特异度0.679。结论血清肌酐、尿酸、尿素氮可反应妊娠期高血压疾病早期肾损害及病情发展；血清尿酸水平对重度子痫前期有预测价值。
Abstract:
ObjectiveTo observe the changes of serum creatinine, urea nitrogen and uric acid in the early stage of hypertensive disorders in pregnancy and the correlation between the three indexes and the severity of the disease.MethodsA total 34 patients with gestational hypertension (gestational hypertension group), 25 cases of patients with mild pre-eclampsia (mild preeclampsia group) and 31 cases of severe pre-eclampsia patients (severe preeclampsia group) were selected from those who were established and delivered at General Hospital of Eastern Theater Command from January 2017 to December 2019 to make a retrospective analysis. The participants were diagnosed with hypertension during pregnancy after hospitalization and gave birth within 1-2 weeks of hospitalization. At the same time, 50 cases (normal pregnancy group) of normal pregnant women were randomly selected as a control group. The general situation and serum creatinine, urea nitrogen, uric acid levels 2 weeks before delivery of four groups of mothers were collected to conduct an analysis and a comparison.Results① There were significant differences in serum creatinine, urea nitrogen, uric acid in each group（P＜0.05）.② The changes of serum creatinine, urea nitrogen and uric acid levels in each group were positively related tothe severity of the disease（normal pregnancy group < gestational hypertension group < mild preeclampsia group < severe preeclampsia group）. The values of serum creatinine, urea nitrogen and uric acid in the gestational hypertension group were 19.57%, 11.40% and 13.46%, which were higher than those in the control group. The indexes in mild preeclampsia group were 30.99%, 25.46%, 31.42%, which were higher than those in the normal pregnancy group, respectively. Compared with the control group, severe preeclampsia group were increased by 50.87%, 41.65% and 57.62%, respectively.③ Elevated serum uric acid level was a risk factor for the occurrence of severe pre-eclampsia [OR(95%CI): 1.013(1.007-1.018), P<0.01].The ROC curve showed that the serum uric acid value of 327.0 �?倕 mol/L was the best predicted for the occurrence of severe pre-eclampsia, with sensitivity of 0.806 and specificity of 0.679.ConclusionSerum creatinine, uric acid and urea nitrogen can suggest an early kidney damage and disease development of hypertensive disorder complicating pregnancy. The level of serum uric acid is worthy of a prediction for pre-eclampsia.

参考文献/References:

[1]杨孜,张为远.妊娠期高血压疾病诊治指南(2015)[J].中华围产医学杂志,2016,19(03):161-169.
[2]Phipps E, Prasanna D, Brima W, et al. Preeclampsia: Updates in Pathogenesis, Definitions, and Guidelines[J]. Clin J Am Soc Nephrol，2016，11(6):1102-1113.
[3]赵群,孔祥.妊娠期高血压病与炎症相关性的研究进展[J].医学研究生学报,2012,25(3):308-311.
[4]Tangren JS, Wan Md Adnan WAH, Powe CE, et al.Risk of Preeclampsia and Pregnancy Complications in Women With a History of Acute Kidney Injury[J]. Hypertension,2018,72(2)：451-459.
[5]李可,朱大伟,陈建昆,等.子痫前期发病机制与临床治疗研究进展[J].解放军医学杂志,2019,44(5):423-429.
[6]蒋艳敏,方大俊,刘慧姝.美国妇产科医师协会(ACOG)妊娠期高血压疾病小组最新报告解析[J].中国实用妇科与产科杂志,2014,30(6):493-495.
[7]金友存,龚芳,华玉蓉.血清CysC、β2-MG在妊娠期高血压疾病早期肾功能损伤中的意义[J].重庆医学,2015,44(33):4630-4631，4634.
[8]Son GH, Kwon JY, Lee S, et al. Comparison of serum and urinary nephrin levels between normal pregnancies and severe preeclampsia[J]. Eur J Obstet Gynecol Reprod Biol,2013,166(2):139-144.
[9]池晓华,李贵平,刘峰,等.GFR、血肌酐及24h尿蛋白定量在评价糖尿病患者肾功能中的应用[J].核技术,2013,36(6):31-34.
[10]Hussein W, Lafayette RA. Renal function in normal and disordered pregnancy[J]. Curr Opin Nephrol Hypertens,2014,23(1)：46-53.
[11]Kattah AG, Asad R, Scantlebury DC, et al.Hypertension in pregnancy is a risk factor for microalbuminuria later in life[J]. J Clin Hypertens (Greenwich),2013,15(9)：617-623.
[12]孙雪峰.慢性肾功能不全的临床诊治思路[J].中国实用内科杂志,2007，27(16):1328-1330.
[13]王超英,何金红.高尿酸血症与高血压、肥胖、高血脂、糖尿病的关系分析[J].实用医学杂志,2010,26(5):819-821.
[14]崔刘福,杨文浩,舒荣,等.中老年人高尿酸血症与心脑血管疾病危险因素相关性的研究[J].中国实用内科杂志,2009,29(7):654-655.
[15]徐亚玲,常颖,陈叙.子痫前期预测指标的临床应用研究进展［J］. 国际妇产科学杂志,2016,43(1): 11-14.
[16]Laughon SK，Catov J，Powers RW，et al．First trimester uric acid and adverse pregnancy outcomes［J］．Am J Hypertens，2011，24(4):489495-489504.

相似文献/References:

备注/Memo

备注/Memo:
-
更新日期/Last Update: 2021-08-10