摘要
目的:探讨妊娠高血压综合征(PIH)患者血清肌钙蛋白I(cTnI)、肌红蛋白(Mb)、B型脑钠肽(BNP)水平变化及与不良妊娠结局关系和预测价值。方法:选取2020年5月-2022年5月在本院产前检查并分娩的PIH患者120例,其中子痫前期组(n=41)和单纯高血压组(n=79),同期健康孕产妇60例为对照组。对比各组妊娠中期(22~28周)血清cTnI、Mb及BNP水平及不良妊娠结局情况,分析cTnI、Mb及BNP水平与不良妊娠结局关系及预测价值(受试者工作特征曲线分析)。结果:血清cTnI、Mb及BNP水平在对照组(0.06±0.02μg/L、17.12±1.25 ng/ml、59.65±13.74μmol/L)、单纯高血压组(0.35±0.07μg/L、43.25±9.46 ng/ml、87.34±11.21μmol/L)、子痫前期组(0.62±0.04μg/L、61.26±10.71 ng/ml、174.51±12.93μmol/L)依次升高,PIH患者血清cTnI、Mb及BNP水平均与PIH疾病程度呈正相关;总不良妊娠结局对照组、单纯高血压组、子痫前期组依次升高(10.0%、22.8%、41.5%);PIH组妊娠结局不良者孕中期血清cTnI、Mb及BNP水平均高于妊娠结局良好者,且对不良妊娠结局均有预测价值,曲线下面积分别为0.815、0.797、0.804)(均P<0.05)。结论:PIH患者存在心肌损伤现象,且随着病情加重心肌损伤加重,孕中期血清cTnI、Mb及BNP可作为预测不良妊娠结局的参考指标。
Objective:To explore the correlation between the levels of cardiac troponin I(cTnI),myoglobin(Mb),and B type natriuretic peptide(BNP)of pregnant women with pregnancy induced hypertension(PIH)and their adverse pregnancy outcomes.Methods:A total of 120pregnant women with PIH who had been prenatal examination and delivered in the hospital were enrolled and were divided into group A(41women with preeclampsia)and group B(79 women with hypertension only)between May 2020and May 2022.60healthy pregnant women were enrolled in group C during the same period.The levels of cTnI,Mb,and BNP during the second trimester of pregnancy(22-28gestational weeks)and the adverse pregnancy outcomes of the women were compared among the three groups.The correlation between the levels of cTnI,Mb,and BNP of the women and their adverse pregnancy outcomes was analyzed.The values of the levels of cTnI,Mb,and BNP of the women for predicting their adverse pregnancy outcomes was analyzed by receiver operator characteristic(ROC)curve.Results:The levels of serum cTnI,Mb,and BNP of the women in group C(0.06±0.02μg/L,17.12±1.25ng/ml,and 59.65±13.74μmol/L),in group B(0.35±0.07μg/L,43.25±9.46 ng/ml,and 87.34±11.21μmol/L),and in group A(0.62±0.04μg/L,61.26±10.71ng/ml,and 174.51±12.93μmol/L)had increased gradually.The levels of serum cTnI,Mb,and BNP of the women with PIH were positively correlated with their severity of PIH.The total rates of adverse pregnancy outcomes of the women in group C,in group B,and in group A were 10.0%,22.8%,and 41.5%,respectively,which had increased gradually.In group A,the serum levels of cTnI,Mb,and BNP of the women with adverse pregnancy outcomes during the second trimester of pregnancy were significantly higher than those of the women with normal pregnancy outcomes.The areas under the curve serum levels of cTnI,Mb,and BNP of the women for predicting their adverse pregnancy outcomes were 0.815,0.797,and 0.804,respectively(all P<0.05).Conclusion:The pregnant women with PIH have myocardial injury,and the myocardial injury is aggravated with their severe PIH.The levels of serum cTnI,Mb,and BNP of the women during the second trimester of pregnancy can be used as the reference indicators to predict their adverse pregnancy outcomes.
作者
黄珂
王瑜琦
任晶晶
何珂
HUANG Ke;WANG Yuqi;REN Jingjing;HE Ke(Sichuan Gem Flower Hospital,Chengdu,Sichuan Province,610213;Shuangliu District Maternal and Child Health Hospital of Chengdu;Chengdu Maria Tianfu Maternity and Children's Hospital)
出处
《中国计划生育学杂志》
2023年第12期2977-2980,2985,共5页
Chinese Journal of Family Planning
关键词
妊娠高血压综合征
孕中期
肌钙蛋白I
肌红蛋白
B型脑钠肽
不良妊娠结局
预测
Pregnancy induced hypertension
The second trimester of pregnancy
Cardiac troponin I
Myoglobin
B type natriuretic peptide
Adverse pregnancy outcomes
Prediction
