妊娠期肾病综合征发病危险因素及临床筛查、预测妊娠结局价值  

Risk factors of nephrotic syndrome of pregnancy of women and their values for screening nephrotic syndrome occurrence in clinic and predicting the pregnancy outcomes of these women

作　　者：王婷婷[1] 魏璞 何倩 史金凤[1] WANG Tingting;WEI Pu;HE Qian;SHI Jinfeng(The First People's Hospital of Hangzhou,Hangzhou,Zhejiang Province,310006;Zhejiang Maternal and Child Health Center,Hangzhou)

机构地区：[1]浙江省杭州市第一人民医院,310006 [2]浙江省妇幼和生殖保健中心

出　　处：《中国计划生育学杂志》2023年第2期397-401,共5页Chinese Journal of Family Planning

摘　　要：目的:探究妊娠期肾病综合征(NSP)发病影响因素及其在临床筛查、妊娠结局预测效能。方法:选取2018年1月-2022年1月本院收治的NSP患者39例(NSP组)及未合并NSP的重度子痫前期患者54例(对照组)临床资料,收集基线资料、血压指标、实验室指标并对比分析,多因素logistic回归模型分析NSP发病的危险因素,根据新生儿窒息发生情况分为妊娠结局不良组、良好组,对比两组危险因素指标差异,绘制受试者工作特征曲线(ROC)分析以上危险因素在NSP临床筛查与妊娠结局不良诊断价值。结果:NSP组收缩压(SBP)、空腹血糖(FBG)、同胱抑素-C(CysC)、总胆固醇(TC)、三酰甘油(TG)、尿素氮(BUN)水平均高于对照组,同型半胱氨酸(Hcy)、血浆总蛋白(TPP)、白蛋白(Alb)水平均低于对照组(P<0.05)。NSP发病危险因素是SBP、FBG、CysC,保护因素是Alb、TPP(P<0.05);SBP、FBG、Alb、CysC、TTP在NSP临床筛查中的曲线下面积(AUC)均>0.75,敏感度、特异度均>70.0%;妊娠结局不良组SBP、FBG高于良好组(P<0.05),SBP、FBG预测患者不良妊娠结局预测中的AUC=0.800、0.814,敏感度73.3%、86.3%,特异度77.0%、80.0%。结论:NSP患者血清SBP、FBG、CysC、Hcy、Alb、TPP发生异常,SBP、FBG、CysC、Alb、TPP指标均是NSP发病的影响因素且均可作为临床筛查NSP的敏感指标;SBP、FBG可作为预测患者发生新生儿窒息的敏感指标。Objective: To explore the influence factors of nephrotic syndrome of pregnancy(NSP) of women during pregnancy, and to study their efficiency for screening NSP in clinic and predicting the pregnancy outcomes of these women. Methods: From January 2018 to January 2022, the clinical data of 39 pregnant women with NSP(in study group) and 54 pregnant women with pregnancy-induced hypertensive severe preeclampsia and without NSP(in control group) were selected in this study. The baseline data, the blood pressure values, the laboratory indexes levels of the women in the two groups were collected and were comparison analyzed. Multivariable logistic regression model was used to analyze the risk factors of NSP. According to the situation of neonatal asphyxia, these women were divided into group A(women with adverse pregnancy outcomes) and group B(women with normal pregnancy outcomes), and the differences of the risk factors indicators of the women were compared between group A and group B. Receiver operating characteristic(ROC) curve was drawn to analyze the values of the risk factors for screening NSP in clinic and diagnosing the adverse pregnancy outcomes of these women. Results: The systolic blood pressure(SBP) value, and the levels of fasting blood glucose(FBG), homocystatin C(CysC), total cholesterol(TC), triglyceride(TG), and urea nitrogen(BUN) of the women in the study group were significantly higher than those of the women in the control group, while the homocysteine(Hcy),plasma total protein(TPP)and albumin(Alb)levels of the women in the study group were significantly lower than those of the women in the control group(P<0.05).The risk factors of NSP of the women were SBP,FBG and CysC,and the protective factors of NSP of the women were Alb and TPP(P<0.05).The area under curve(AUC)of the level of SBP,FBG,Alb,CysC,or TTP for screening of NSP in clinic was>0.75,and the sensitivity or the specificity of which was> 70.0%.The SBP value and the FBG level of the women in group A were significantly higher than those of the wo

关 键 词：妊娠期肾病综合征 危险因素 临床筛查 妊娠结局 新生儿窒息 预测 

分 类 号：R714.258[医药卫生—妇产科学]