血清尿酸升高对妊娠的影响

目的评价血清尿酸升高妊娠妇女体内各种代谢因子变化，探讨血清尿酸升高对妊娠结局的影响。方法采用回顾性分析法对本院2007年1月至12月分娩的1980例孕妇进行分析，按照病历记载，将60例孕期血清尿酸升高患者纳入A组（n=60），子痫前期患者纳入B组（n=77），妊娠期糖尿病（gestationaldiabetesmellitus，GMD）患者纳入C组（n=88），血清尿酸水平正常者纳入D组（n=1920）。随机抽取D组中临床各项指标无异常的足月分娩孕妇200例纳入对照组（本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准）。分别对4组临床资料进行统计学分析、研究。结果A组（血清尿酸升高组）患者的尿蛋白升高几率高于对照组（血清尿酸正常组），其中尿蛋白异常升高（≥0．3mg／dL）几率显著升高，两组比较，差异有显著意义（X2=0．66，P〉0．05）。A组尿蛋白轻度升高几率与B组（子痫前期组）相近，而B组尿蛋白异常升高（≥0．3mg／dL）的几率显著高于A组（X2=38．68，P〈0．01）。A组与C组（妊娠期糖尿病组）轻型和重型尿蛋白升高几率比较，差异无显著意义（X2=0．08，P〉0．05；X2=0．17，P〉0．05）。A组孕妇以子痫前期或妊娠期糖尿病为结局的几率较D组（血清正常者）显著升高，且差异有显著意义（X2=12．28，P〈0．01；X2=18．90，P〈O．01）。血清肌酐水平异常率偏低，未作比较。结论血清尿酸升高可能是妊娠期肾功能损害的标志，轻微肾损害还达不到子痫前期患者的肾损害的程度。妊娠期血清尿酸升高可增加子痫前期、妊娠期糖尿病患病率。

Retrospective Analysis on the Relationship Between the Increase of Serum Uric Acid and Pregnancy

Objective To discuss the relationship between gestation and the level of blood uric acid. Method From January to December 2007, 1980 pregnant women were divided into 4 groups, 60 cases with the increase of serum uric acid （group A）, 77 cases with pre-eclampsia （group B）, 88 cases with gestational diabetes mellitus （group C）, and other 1920 cases with normal serum uric acid （group D）. At the same time, 200 pregnant women without any abnormal who were selected randomly from group D were taken as control group（n= 200）. The clinical data of all those patients were statistically analyzed. Informed consent was obtained from all participates. Results The increase possibility of urine protein of group A was higher than that of control group, especially the abnormal increase of urine protein （proteinuria≥0. 3 mg/dL）, there had statistical significance between two groups （X2 = 0.66, P〉0.05）. The mild increase possibility of urine protein of group A was similar to group B, but abnormal increase possibility of group B （proteinuria≥ 0.3 mg/dL） was significant higher than that of group A（X2 = 38.68,P〈0.01）. There had no significant differences of mild or severe increase possibility of urine protein between group A and C （X2 = 0. 08, P2〉 0.05;）X2=0. 17,P〉0.05）. The prevalence of pre-eclampsia and gestational diabetes mellitus in group A was higher than that of group D（X2= 12.28,P〈0.01;X2 = 18.90, P〈0.01）. Conclusion The increase of serum uric acid appears to be useful in forecasting the dysfunction of kidney in pregnancy, but it can not be one of sensitive indexes to examine pre-eclampsia. The increase of level of serum uric acid may raise prevalence of pre-eclampsia and gestational diabetes mellitus during pregnancy.