血清NT-proBNP对妊娠期高血压孕妇及围生儿预后的临床价值  

Clinical value of serum NT-proBNP on the prognosis of pregnant women with hypertension during pregnancy and their perinatal infants

作　　者：黄军 官燕飞[1] 彭建明[1] 童辉纯 HUANG Jun;GUAN Yanfei;PENG Jianming;TONG Huichun(Department of Clinical Laboratory,Zhongshan Boai Hospital Affiliated to Southern Medical University,Zhongshan,Guangdong 528400,China)

机构地区：[1]南方医科大学附属中山市博爱医院检验科,广东中山528400

出　　处：《检验医学与临床》2021年第14期2002-2005,2010,共5页Laboratory Medicine and Clinic

基　　金：广东省医学科研基金项目(A2019348);中山市社会公益与基础研究立项项目(2020B1066)。

摘　　要：目的探讨妊娠期高血压疾病孕妇血清N末端B型脑钠肽前体(NT-proBNP)水平变化情况及临床意义。方法选取2017年1月至2018年6月在该院住院的317例单胎妊娠孕妇作为研究对象。根据相关标准将其分为妊娠期高血压组48例,轻度子痫前期组47例,重度子痫前期组114例,对照组108例。采用酶联免疫吸附试验检测4组血清NT-proBNP水平。收集相关临床资料,分析NT-proBNP水平与不同妊娠状态孕妇及围生儿预后的关系。结果重度子痫前期组血清NT-proBNP、尿素氮(BUN)、肌酐(Cr)、尿酸(UA)和胱抑素C(Cys C)水平明显高于对照组、妊娠期高血压组和轻度子痫前期组,差异有统计学意义(P<0.05)。轻度子痫前期组和重度子痫前期组的胎儿宫内发育迟缓、宫内死胎、早产儿和低体质量儿发生率高于对照组(P<0.05)。与对照组比较,轻度子痫前期组、重度子痫前期组新生儿体质量均减少,且重度子痫前期组收缩期峰值(S)/舒张期谷值(D)高于对照组和轻度子痫前期组(P<0.05)。随着NT-proBNP水平升高,宫内死胎、早产儿和低体质量儿发生率升高(P<0.05)。NT-proBNP水平与BUN、Cr、UA和Cys C均呈正相关(r=0.372、0.511、0.353、0.334,P<0.05)。结论重度子痫前期孕妇血清NT-proBNP水平升高明显,检测血清NT-proBNP水平变化情况对判断妊娠期高血压孕妇病情进展和评价围生儿预后具有重要的临床指导意义。Objective To investigate the changes and clinical significance of serum N-terminal B-type pro-brain natriuretic peptide(NT-proBNP)levels in pregnant women with hypertension during pregnancy.Methods A total of 317 singleton pregnant women who were hospitalized from January 2017 to June 2018 were selected as the research subjects.According to relevant standards,they were divided into 48 cases of pregnancy induced hypertension group,47 cases of mild preeclampsia group,114 cases of severe preeclampsia group,and 108 cases of control group.Enzyme-linked immunosorbent assay was used to detect serum NT-proBNP levels in the 4 groups.The relevant clinical data was collected,the relationship between NT-proBNP level and the prognosis of pregnant women and perinatal babies in different pregnancy status were analyzed.Results The levels of NT-proBNP,BUN,Cr,UA and Cys C in severe preeclampsia group were significantly higher than those in control group,pregnancy induced hypertension group and mild preeclampsia group(P<0.05).The incidences of intrauterine growth retardation,intrauterine stillbirth,premature infants and low body weight infants in mild preeclampsia group and severe preeclampsia group were higher than those in control group(P<0.05).Compared with the control group,the weight of newborns in the mild preeclampsia group and the severe preeclampsia group decreased,and the peak systolic(S)/valley diastolic(D)value in the severe preeclampsia group was higher than that in the control group and the mild preeclampsia group(P<0.05).With the increase of NT-proBNP level,the incidence of intrauterine stillbirth,premature infants and low body weight infants increased(P<0.05).NT-proBNP level was positively correlated with BUN,Cr,UA and Cys C(r=0.372,0.511,0.353,0.334,P<0.05).Conclusion The serum NT-proBNP level of pregnant women with severe preeclampsia increases significantly.The detection of serum NT-proBNP level has important clinical significance in judging the progress of pregnancy induced hypertension and evaluating perinatal

关 键 词：N末端B型脑钠肽前体 妊娠期高血压 围生儿预后 

分 类 号：R714.25[医药卫生—妇产科学]