血清血红素加氧酶1、超氧化物歧化酶、谷胱甘肽过氧化物酶水平与妊娠期高血压疾病胎儿宫内缺氧的关系  

The relationship between the levels of serum heme oxygenase 1,superoxide dismutase,gluta-thione peroxidase and the fetal intrauterine hypoxia in hypertensive disorders of pregnancy

作　　者：卢勇 贾立杨 毕新颖 张艳彬 褚文静 LU Yong;JIA Li-yang;BI Xin-ying;ZHANG Yan-bin;CHU Wen-jing(Department of Gynaecology and Obstetrics,Cangzhou People’s Hospital,Cangzhou 061000,China;Department of Ultrasound,Cangzhou People’s Hospital,Cangzhou 061000,China)

机构地区：[1]河北省沧州市人民医院妇产科,河北沧州061000 [2]河北省沧州市人民医院超声科,河北沧州061000

出　　处：《实用医院临床杂志》2025年第2期91-95,共5页Practical Journal of Clinical Medicine

基　　金：河北省卫健委科研基金资助项目(编号:20200291);沧州市重点研发计划指导项目(编号:222106052)。

摘　　要：目的研究血清血红素加氧酶1(HO-1)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)水平与妊娠期高血压疾病胎儿宫内缺氧的关系,为预防胎儿宫内缺氧提供指导。方法2023年1~10月于我院治疗的重度子痫前期患者30例,按1∶1比例分别收集30例子痫前期和妊娠期高血压患者,均于产检时留取完整血样,检测其HO-1、SOD及GSH-PX水平,均接受子宫动脉彩色多普勒超声检查,比较大脑中动脉血流动力学指标,并记录各组患者的妊娠结局,统计胎儿宫内缺氧发生情况,比较是否发生宫内缺氧患者的上述指标水平,分析其预测妊娠期高血压胎儿宫内缺氧风险的价值。结果三组胎儿大脑中动脉搏动指数(PI)、收缩期峰值血液流速比舒张末期血液流速(S/D)、阻力指数(RI)、HO-1、SOD及GSH-PX水平比较,重度子痫前期组<子痫前期组<妊娠期高血压组,差异均有统计学意义(P<0.05);90例妊娠期高血压患者中存在29例胎儿宫内缺氧(胎儿宫内缺氧组),胎儿宫内缺氧组胎儿中动脉PI、S/D、RI、HO-1、SOD及GSH-PX均较无胎儿宫内缺氧组低(P<0.05);胎儿大脑中动脉血流动力学指标及妊娠期高血压孕妇HO-1、SOD及GSH-PX水平预测胎儿宫内缺氧的效能较高,其中联合预测效能最高,当其Youden指数为0.539时,曲线下面积(AUC)为0.762,预测胎儿宫内缺氧的敏感度为96.55%,特异度为57.38%。结论妊娠期高血压患者血清HO-1、SOD及GSH-PX水平较低,可反映其疾病严重程度,且联合胎儿大脑中动脉血流参数可有效预测胎儿宫内缺氧,对胎儿宫内缺氧的预防具有指导意义。Objective To investigate the relationship between the levels of serum heme oxygenase-1(HO-1),superoxide dismutase(SOD)and glutathione peroxidase(GSH-PX)and the fetal intrauterine hypoxia in hypertensive disorder of pregnancy,so as to provide guidance for preventing fetal intrauterine hypoxia.Methods Thirty patients with severe preeclampsia in our hospital from January 2023 to October 2023 were collected.Another 30 patients with preeclampsia and 30 patients with gestational hypertension were collected at 1:1 ratio.Complete blood samples were collected at the time of prenatal examination.The levels of HO-1,SOD and GSH-PX were detected.All patients received color Doppler ultrasound examination of uterine artery.The hemodynamic indicators of the middle cerebral artery were compared.The pregnancy outcome of each group was recorded.The incidence of fetal intrauterine hypoxia was counted.The levels of the above indicators in patients with or without intrauterine hypoxia were compared.The value on predicting the risk of fetal intrauterine hypoxia in gestational hypertension was analyzed.Results The pulsatility index(PI),peak systolic velocity/end diastolic velocity(S/D)and resistance index(RI)of fetal middle cerebral artery and the levels of HO-1,SOD and GSH-PX among the three groups showed that severe preeclampsia grouP<preeclampsia group<gestational hypertension group(P<0.05).Among the 90 cases of gestational hypertension,29 cases had fetal intrauterine hypoxia(fetal intrauterine hypoxia group).The PI,S/D,RI,HO-1,SOD and GSH-PX of fetal middle artery in the fetal intrauterine hypoxia group were lower than those in the non-fetal intrauterine hypoxia group(P<0.05).The hemodynamic indicators of fetal middle cerebral artery and the levels of HO-1,SOD and GSH-PX in pregnant women with gestational hypertension had high predictive efficiency on fetal intrauterine hypoxia.The combined predictive efficiency was the highest.When the Youden index was 0.539,the area under the curve(AUC)of ROC curve analysis was 0.762.The sensitivi

关 键 词：血清血红素加氧酶1 超氧化物歧化酶 谷胱甘肽过氧化物酶 妊娠期高血压 胎儿宫内缺氧 

分 类 号：R714.5[医药卫生—妇产科学]