血NT-proBNP、炎性因子与早发型子痫前期发生和不良妊娠结局的关系

目的 探讨血NT-proBNP和炎性细胞因子水平与早发型子痫前期发生和不良妊娠结局的关系.方法 收集早发型子痫前期患者74例,其中轻度组23例、重度组51例.另外选择同期在本院进行产前检查的正常孕妇50例作为对照组.比较三组收缩压、舒张压、尿肌酐、尿素氮、血浆NT-proBNP、hs-CRP、TNF-α、IL-6水平、新生儿体重及分娩孕周情况,比较两组患者的不良妊娠结局情况.对重度组出现不良妊娠结局和未出现不良妊娠结局患者的血压、血肌酐、尿素氮及血浆NT-proBNP、hs-CRP、TNF-α、IL-6水平进行比较.结果 轻、重度早发型子痫前期患者的收缩压、舒张压、尿肌酐、尿素氮、血浆NT-proBNP、hs-CRP、TNF-α、IL-6水平及新生儿体重明显高于对照组,分娩孕周明显低于对照组(P＜0.05);重度组的收缩压、舒张压、血肌酐、尿素氮、血浆NT-proBNP、hs-CRP、TNF-α、IL-6水平明显高于轻度组,新生儿出生体重明显低于轻度组(P＜0.05).重度组的胎儿生长受限、低蛋白血症、胎盘早剥发生率明显高于轻度组(P＜0.05).51例早发型重度子痫前期患者中,出现不良妊娠结局者血浆NT-proBNP、hs-CRP、TNF-α、IL-6水平明显高于未出现不良妊娠结局者(P＜0.05).结论 早发型子痫前期患者血NT-proBNP、hs-CRP、TNF-α、IL-6水平明显升高,且随病情严重程度增加而升高,其对不良妊娠结局的预测敏感性优于血肌酐和尿素氮,故对早发型子痫前期的诊断及预后评估有一定的临床价值.

Relationship between serum NT-proBNP,inflammatory factors and early onset preeclampsia,adverse pregnancy outcomes

Objective To investigate the relationship between the levels of serum NT-proBNP,inflammatory cytokines and early onset preeclampsia,adverse pregnancy outcomes.Methods 74 patients with early onset preeclampsia were collected,in whom there were 23 mild cases and 51 severe cases.In addition,50 normal pregnant women were selected as control group.The systolic blood pressure,diastolic blood pressure,urinary creatinine,urea nitrogen,serum NT-proBNP,hs-CRP,TNF-α,IL-6,neonatal weight,and gestational age were compared among the three groups,and the adverse pregnancy outcomes were compared between the patients of two preeclampsia groups.The blood pressure,serum creatinine,urea nitrogen,and serum NT-proBNP,hsCRP,TNF-α,IL-6 levels were compared between the patients with adverse pregnancy outcomes and the patients without adverse pregnancy outcomes in the severe group.Results The systolic blood pressure,diastolic blood pressure,urine creatinine,urea nitrogen,serum NT-proBNP,hs-CRP,TNF-α,IL-6 level,and neonatal weight of the patients in the two groups were significantly higher than those of the control group,the gestational age was significantly lower than that of the control group (P＜0.05);the systolic blood pressure,diastolic blood pressure,urine creatinine,urea nitrogen,serum NT-proBNP,hs-CRP,TNF-α,IL-6 levels in the severe group were significantly higher than those in the mild group,the neonatal weight was significantly lower than that in the mild group (P＜0.05).The incidences of fetal growth restriction,hypoproteinemia,and placental abruption in the severe group were significantly higher than those in the mild group (P＜0.05).Among 51 patients with early onset severe preeclampsia,the serum NT-proBNP,hs-CRP,TNF-α,IL-6 levels of the patients with adverse pregnancy outcomes were significantly higher than those of the patients without adverse pregnancy outcomes (P＜0.05).Conclusions The serum NT-proBNP,hs-CRP,TNF-α,IL-6 levels of the patients with early onset preeclampsia increased significantly,and which increased with the severity of the disease increased,those were more sensitive than serum creatinine and blood urea nitrogen for adverse pregnancy outcomes prediction.So they have a certain clinical value of the diagnosis and prognosis evaluation for early onset preeclampsia.