摘要
目的 分析血管紧张素Ⅱ1型受体自身抗体(AT1-AA)、血尿酸、血尿素氮与妊娠期高血压疾病(HDCP)的相关性.方法 选取2021年8月至2023年2月在天津市宝坻区人民医院产科明确诊断HDCP患者125例(HDCP组),另选取同期该院收治的55例健康孕妇作为对照组.根据病情发展程度,将HDCP组分为妊娠高血压组(n=77)、子痫前期组(n=48)两个亚组.检测并比较HDCP组与对照组、妊娠高血压组与子痫前期组血尿酸、血尿素氮、AT1-AA水平等指标.结果 HDCP组与对照组年龄、妊娠时间、D-二聚体、血钙、血肌酐等指标比较差异无统计学意义(P>0.05).HDCP组外周血中AT1-AA、血尿酸及血尿素氮水平高于对照组,差异有统计学意义(P<0.05).子痫前期组外周血中AT1-AA、血尿酸及血尿素氮水平高于妊娠高血压组,差异有统计学意义(P<0.05).采用Spearman秩相关系数分析外周血中AT1-AA(r=0.301)、血尿酸(r=0.380)及血尿素氮(r=0.257)水平与HDCP严重程度呈正相关(P<0.01).AT1-AA、血尿酸、血尿素氮单独检测及联合检测诊断HDCP的曲线下面积(AUC)分别为0.680、0.714、0.647、0.725,其对应的约登系数为0.368、0.380、0.306、0.439,联合检测的价值高于单独检测.结论 AT1-AA、血尿酸、血尿素氮与HDCP的发生、发展存在相关性,3项联合检测的价值更高.
Abstract
Objective To analyze the relationship between angiotensin type Ⅱ 1 receptor autoantibodies (AT1-AA),blood uric acid and urea nitrogen with hypertensive disorder complicating pregnancy (HDCP). Methods A total of 125 patients with HDCP diagnosed in the obstetrics department of Tianjin Municipal Bao-di District People's Hospital from August 2021 to February 2023 were randomly selected as the HDCP group, and 55 healthy pregnant women admitted to this hospital during the same period were selected as the control group.The HDCP group was divided into the gestational hypertension subgroup (n=77) and preeclampsia group (n=48) according to the degree of disease progression.The levels of serum uric acid,blood urea nitro-gen and AT1-AA were detected and compared between the HDCP group and control group and between the gestational hypertension subgroup and preeclampsia subgroup.Results There were no statistically significant differences in the age,gestational time,D-dimer,serum calcium and serum creatinine between the control group and the HDCP group (P>0.05).The levels of peripheral blood AT1-AA,serum uric acid and blood u-rea nitrogen in the HDCP group were higher than those in the control group,and the differences were statisti-cally significant (P<0.05).The levels of peripheral blood AT1-AA,serum uric acid and blood urea nitrogen in the preeclampsia subgroup were significantly higher than those in the gestational hypertension subgroup, and the differences were statistically significant (P<0.05).The Spearman rank correlation coefficient analysis showed that the levels of peripheral blood AT1-AA (r=0.301),serum uric acid (r=0.380) and blood urea nitrogen (r=0.257) levels were positively correlated with the severity degree of HDCP (P<0.01).The area under the curve (AUC) of AT1-AA,serum uric acid and blood urea nitrogen detection alone and combined de-tection in the diagnosis of HDCP were 0.680,0.714,0.647 and 0.725,and the corresponding Youden coeffi-cients were 0.368,0.380,0.306 and 0.439,indicating that the value of combined testing was higher than that of single item detection in the diagnosis of HDCP.Conclusion AT1-AA,serum uric acid and blood urea nitro-gen are correlated with the occurrence and development of HDCP,and the 3-item combined detection has high-er value.