重度子痫前期患者孕晚期血清尿素氮/肌酐比值与胎儿体重的关系研究  

Relationship between blood urea nitrogen/creatinine ratio and fetal weight in patients with severe preeclampsia during late preg-nancy

作　　者：张孝认[1] 周旭平 徐琼飞 吴巧萍[1] ZHANG Xiaoren;ZHOU Xuping;XU Qiongfei;WU Qiaoping(Department of Clinical Laboratory,Ningbo Medical Centre Lihuili Hospital,Ningbo 315048,China;不详)

机构地区：[1]宁波市医疗中心李惠利医院检验科,315048 [2]宁波大学附属妇女儿童医院产科

出　　处：《浙江医学》2024年第20期2167-2172,共6页Zhejiang Medical Journal

摘　　要：目的探讨重度子痫前期(PE)患者孕晚期血清尿素氮(BUN)/肌酐(Cr)比值与胎儿体重的关系。方法采用病例对照研究,选取2021年1月至2022年12月宁波市医疗中心李惠利医院及宁波大学附属妇女儿童医院收治的孕晚期重度PE患者200例,另选取同期入院待产的非高血压孕妇200例作为对照。收集孕妇临床资料,抽取空腹静脉血5 mL检测BUN、Cr等生化指标,观察重度PE患者BUN/Cr比值变化及胎儿体重特点;重度PE患者中发生胎儿生长受限(FGR)58例作为FGR组,未发生FGR 142例作为非FGR组,比较两组间BUN/Cr比值等血清生化指标及临床特点差异,分析重度PE患者孕晚期血清BUN/Cr比值对FGR发生的影响,血清BUN/Cr比值与胎儿出生体重的相关性。结果与非高血压组比较,重度PE组BUN/Cr比值较高,胎儿FGR发生率较高,胎儿出生体重较小,差异均有统计学意义(均P<0.05);BUN/Cr比值是重度PE患者发生FGR的独立危险因素(OR=1.176,95%CI:1.100~1.258,P<0.001);孕前BMI、孕期增重、分娩孕周与胎儿出生体重均呈正相关(r=0.158、0.173、0.798,P=0.027、0.014、<0.001),BUN/Cr、尿酸水平与胎儿出生体重均呈负相关(r=-0.477、-0.226,P<0.001、0.001);排除孕前BMI、孕期增重、分娩孕周及尿酸水平对胎儿出生体重的影响外,BUN/Cr比值与胎儿出生体重呈负相关(r=-0.389,P<0.001)。结论重度PE患者血清BUN/Cr比值与胎儿出生体重呈负相关,是重度PE患者发生FGR的独立危险因素。Objective To investigate the relationship between blood urea nitrogen(BUN)/creatinine(Cr)ratio and fetal weight in patients with severe preeclampsia(PE)during late pregnancy.Methods This case-control study enrolled 200 cases of severe PE during late pregnancy who were admitted to Ningbo Medical Centre Lihuili Hospital and Women and Children's Hospital of Ningbo University from January 2021 to December 2022.Another 200 cases of non-hypertensive pregnant women who were hospitalized for delivery during the same period were selected as controls.Clinical data of pregnancy women were collected,and their fasting venous blood was collected to detect BUN,Cr and other biochemical indexes.The changes of BUN/Cr and fetal birth weight(BW)in patients with severe PE were observed.Fifty-eight patients with severe PE combined with fetal growth restriction(FGR)were classified as the FGR group,and 142 patients without FGR were classified as the non FGR group.The two groups were compared in serum biochemical indexes such as BUN/Cr ratio and clinical characteristics.The effects of BUN/Cr ratio on the occurrence of FGR and the correlation between BUN/Cr ratio and fetal BW were analyzed.Results Compared to the non-hypertensive group,severe PE group had higher BUN/Cr ratio,higher incidence of FGR,and lower fetal BW,and the differences were statistically significant(all P<0.05).Serum BUN/Cr ratio was an independent risk glutamyl transfer-factor for FGR in patients with severe PE(OR=1.176,95%CI:1.100-1.258,P<0.001).Pre-pregnancy BMI,weight gain during pregnancy,and gestational week were positively correlated with fetal BW(r=0.158、0.173、0.798,P=0.027、0.014、0.001),BUN/Cr and uric acid(UA)levels were negatively correlated with fetal BW(r=-0.477,-0.226,P<0.001、0.001).When excluding the effects of pre-pregnancy BMI,pregnancy weight gain,gestational week and UA on fetal BW,BUN/Cr ratio was negatively correlated with fetal BW(r=-0.389,P<0.001).Conclusion Serum BUN/Cr ratio in patients with severe PE was negatively correlated with fetal

关 键 词：子痫前期 胎儿生长受限 出生体重 尿素氮 肌酐 

分 类 号：R714.244[医药卫生—妇产科学] R714.5[医药卫生—临床医学]