妊娠期高血压疾病患者尿蛋白肌酐比值、血浆D-二聚体水平与不良妊娠结局的关系分析  

Correlation of urinary protein creatinine ratio and plasma D-dimer level with adverse pregnancy outcome in patients with hypertensive disorder complicating pregnancy

作　　者：黄卉 尚丽 俞晓倩 高霞[1] Huang Hui;Shang Li;Yu Xiaoqian;Gao Xia(Department of Obstetrics,Shiyan People's Hospital,Shiyan 442000,China)

机构地区：[1]十堰市人民医院产科,十堰442000

出　　处：《中国实用医刊》2022年第17期26-29,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨妊娠期高血压疾病(HDCP)患者尿蛋白肌酐比值(ACR)、血浆D-二聚体(D-D)水平与不良妊娠结局的关系。方法回顾性分析十堰市人民医院2021年10月至2021年11月收治的60例HDCP患者的临床资料,将发生不良妊娠结局的21例患者纳入观察组,将未发生不良妊娠结局的39例患者纳入对照组。采集60例HDCP患者静脉血进行检测,比较两组ACR、D-D的差异;应用多因素Logistic回归分析模型分析ACR、D-D与不良妊娠结局发生的关系;绘制受试者工作特征曲线,分析ACR与D-D单独与联合预测不良妊娠结局的价值。结果观察组ACR、D-D水平[(34.84±5.21)g/mol、(3.75±1.02)mg/L]高于对照组[(27.49±3.48)g/mol、(2.38±0.67)mg/L],P<0.05;多因素Logistic回归分析结果显示,ACR、D-D与HDCP患者不良妊娠结局有关(P<0.05);绘制受试者工作特征曲线结果显示,ACR联合D-D预测HDCP不良妊娠结局发生的曲线下面积为0.939(95%CI:0.860~1.000),高于ACR、D-D单独预测的0.776(95%CI:0.648~0.904)、0.760(95%CI:0.640~0.880)。结论ACR、D-D水平升高是HDCP患者发生不良妊娠结局的独立危险因素,及时对两项指标进行检测可尽早预测不良妊娠结局,继而指导临床施行针对性防范措施,以尽可能减少不良妊娠结局的发生。Objective To investigate the correlation of urinary albumin to creatinine ratio(ACR)and plasma D-Dimer(D-D)with adverse pregnancy outcomes in women with hypertensive disorder complicating preynancy(HDCP).Methods The clinical data from 60 women with HDCP treated in Shiyan People’s Hospital from October 2021 to November 2021 were analyzed retrospectively.Twenty-one cases with poor pregnancy outcome were allocated into the observation group,and 39 cases without poor pregnancy outcome were allocated into the control group.The venous blood of 60 HDCP women was collected for detection,and the differences of ACR and D-D between the two groups were compared.Multivariate Logistic regression analysis model was used to investigate the correlation of ACR and D-D with adverse pregnancy outcomes.The receiver operating characteristic curve was drawn to analyze the value of ACR,D-D and combination of them in predicting adverse pregnancy outcomes.Results The levels of ACR and D-D in the observation group were(34.84±5.21)g/mol and(3.75±1.02)mg/L,respectively,which were significantly higher than(27.49±3.48)g/mol and(2.38±0.67)mg/L in the control group(P<0.05).Results of multivariate Logistic regression analysis showed that ACR and D-D were related to the adverse pregnancy outcome of HDCP women,and the difference was statistically significant(P<0.05).Receiver operating characteristic curve results showed that the area under the curve of ACR combined with D-D in predicting adverse pregnancy outcomes in HDCP women was 0.939(95%CI:0.860~1.000),which was higher than the 0.776 of ACR(95%CI:0.648~0.904)and 0.760 of D-D(95%CI:0.640~0.880).Conclusions The increases of ACR and D-D levels are independent risk factors for adverse pregnancy outcomes in HDCP women.Timely detection of the two indicators can predict adverse pregnancy outcomes as soon as possible,and then guide the clinical implementation of targeted preventive measures to reduce the occurrence of adverse pregnancy outcomes as much as possible.

关 键 词：妊娠期高血压疾病 尿蛋白肌酐比值 D-二聚体 不良妊娠结局 

分 类 号：R714.246[医药卫生—妇产科学]