子宫动脉血流动力学参数联合24 h尿蛋白D-二聚体及视黄醇结合蛋白4与妊娠期高血压疾病患者妊娠结局的关系分析  

Analysis on the relationships between uterine artery hemodynamic parameters combined with 24-hour urine protein,D-dimer,retinol-binding protein 4 and pregnancy outcome of patients with hypertensive disorder complicating pregnancy

作　　者：陈志鹏 赵文龙[1] 俞佳丽 CHEN Zhi-peng;ZHAO Wen-long;YU Jia-li(Department of Obstetrics,Yiwu Central Hospital,Yiwu,Zhejiang 322000,China)

机构地区：[1]义乌市中心医院产科,浙江义乌322000

出　　处：《中国妇幼保健》2025年第5期943-947,共5页Maternal and Child Health Care of China

基　　金：浙江省自然科学基金项目(LY15H202035)。

摘　　要：目的探讨子宫动脉血流动力学参数联合24 h尿蛋白、D-二聚体、视黄醇结合蛋白4(RBP4)与妊娠期高血压疾病患者妊娠结局的关系。方法收集2021年2月—2022年12月义乌市中心医院收治的妊娠期高血压疾病孕妇80例为妊娠期高血压疾病组,正常妊娠孕妇80例为对照组。采用子宫动脉超声血流显像检测血流动力学参数[搏动指数、阻力指数、收缩期最大血流速度(S)与舒张期末期血流速度(D)的比值(S/D比值)]。收集孕妇24 h尿液,采用双缩脲法检测24 h尿蛋白水平。采用酶联免疫吸附法检测D-二聚体和RBP4水平。比较不同妊娠结局的妊娠期高血压疾病孕妇子宫动脉血流动力学参数、24 h尿蛋白、D-二聚体、RBP4水平。结果妊娠期高血压疾病组孕妇搏动指数(1.42±0.19)、阻力指数(0.80±0.09)、S/D比值(5.08±0.95)均明显高于对照组,差异均有统计学意义(t=7.518、6.094、6.421,均P<0.05)。重度子痫前期组孕妇搏动指数(1.98±0.24)、阻力指数(0.99±0.14)、S/D比值(6.76±1.04)均明显高于轻度子痫前期组、妊娠期高血压组,轻度子痫前期组孕妇搏动指数(1.40±0.21)、阻力指数(0.82±0.10)、S/D比值(5.15±0.95)均明显高于妊娠期高血压组,差异均有统计学意义(均P<0.05)。妊娠期高血压疾病组孕妇24 h尿蛋白[(0.71±0.13)g/24 h]、D-二聚体[(757.96±56.71)μg/L]、RBP4[(41.72±4.90)μg/ml]水平均明显高于对照组,差异均有统计学意义(t=14.508、27.926、21.719,均P<0.05)。重度子痫前期组孕妇24 h尿蛋白[(1.71±0.24)g/24 h]、D-二聚体[(854.72±64.53)μg/L]、RBP4[(60.44±6.11)μg/ml]水平均明显高于轻度子痫前期组、妊娠期高血压组,轻度子痫前期组孕妇24 h尿蛋白[(0.82±0.15)g/24 h]、D-二聚体[(762.76±59.92)μg/L]、RBP4[(43.48±5.05)μg/ml]水平均明显高于妊娠期高血压组,差异均有统计学意义(均P<0.05)。妊娠结局不良的妊娠期高血压疾病孕妇搏动指数(1.91±0.25)、阻力指�Objective To explore the relationships between uterine artery hemodynamic parameters combined with 24-hour urine protein,D-dimer,retinol-binding protein 4(RBP4)and pregnancy outcome of patients with hypertensive disorder complicating pregnancy.Methods A total of 80 pregnant women with hypertensive disorder complicating pregnancy admitted to Yiwu Central Hospital from February 2021 to December 2022 were collected as hypertensive disorder complicating pregnancy group,and 80 normal pregnant women were selected as control group.Uterine artery ultrasound blood flow imaging was used to detect hemodynamic parameters[pulsatility index,resistance index,the ratio of peak systolic velocity to end diastolic velocity(S/D)],24-hour urine specimens were collected from pregnant women to detect 24-hour urine protein content using biuret method.Enzyme-linked immunosorbent assay was used to detect D-dimer and RBP4 levels.The levels of hemodynamic parameters,24-hour urine protein,D-dimer,and RBP4 in pregnant women with hypertensive disorder complicating pregnancy of different pregnancy outcomes were compared.Results Pulsatility index(1.42±0.19),resistance index(0.80±0.09),and S/D ratio(5.08±0.95)in hypertensive disorder complicating pregnancy group were statistically significantly higher than those in control group(t=7.518,6.094,6.421,all P<0.05).Pulsatility index(1.98±0.24),resistance index(0.99±0.14),and S/D ratio(6.76±1.04)in severe preeclampsia group were statistically significantly higher than those in mild preeclampsia group and gestationalhypertension group,pulsatility index(1.40±0.21),resistance index(0.82±0.10),and S/D ratio(5.15±0.95)in mild preeclampsiawere statistically significantly higher than those in gestational hypertension group(all P<0.05).24-Hour urine protein[(0.71±0.13)g/24 hour],D-dimer[(757.96±56.71)μg/L],and RBP4[(41.72±4.90)μg/ml]levels in hypertensive disorder complicatingpregnancy group were statistically significantly higher than those in control group(t=14.508,27.926,21.719,all P<0.05).24-

关 键 词：妊娠期高血压疾病 子宫动脉 血流动力学参数 24 h尿蛋白 D-二聚体 视黄醇结合蛋白4 妊娠结局 

分 类 号：R714.24[医药卫生—妇产科学]