摘要
目的 探讨妊娠高血压疾病患者不良妊娠结局的影响因素.方法 选取2020年4月至2022年6月东莞市人民医院收治的71例妊娠高血压疾病患者为研究对象,采用质谱法测定患者维生素A、D及E水平,对妊娠高血压疾病患者不良妊娠结局可能的影响因素进行单因素和多因素分析.结果 71例妊娠高血压疾病患者经随访发现19例患者妊娠结局不良,52例患者妊娠结局良好.单因素结果显示,妊娠高血压疾病患者预后与年龄、孕产史、高血压家族史、不良孕史、超敏C反应蛋白(hs-CRP)、D-二聚体(D-D)、维生素D、总胆红素无关,差异无统计学意义(P＞0.05);与孕前体重指数(BMI)、病情严重程度、血尿酸、24 h尿蛋白定量、维生素A、维生素E比较,差异有统计学意义(P＜0.05);多因素 logistic 回归结果显示,孕前 BMI(β=1.213,OR=3.582,95％CI=2.482～6.313)、病情严重程度(β=1.563,OR=6.413,95％CI=5.682～8.452)、血尿酸(β=1.456,OR=4.083,95％CI=3.235～4.572)、24 h尿蛋白定量(β=2.938,OR=1.434,95％CI=1.283～4.394)、维生素 A(β=1.691,OR=1.593,95％CI=1.241～1.786)、维生素E(β=1.336,OR=1.246,95％CI=1.187～1.583)是妊娠高血压疾病患者不良预后的独立危险因素,差异有统计学意义(P＜0.05).结论 维生素A、D及E水平在妊娠高血压疾病患者中表达异常,其表达水平能反映疾病严重程度,且患者不良妊娠结局受多种因素的影响,不同因素能相互作用及干预,应针对上述可控因素进行干预.
Abstract
Objective To explore the influencing factors of adverse pregnancy outcomes in patients with gestational hyper-tension.Methods A total of 71 patients with gestational hypertension admitted to Dongguan People's Hospital from April 2020 to June 2022 were selected as the study subjects.The levels of vitamin A,vitamin D,and vitamin E in the patients were measured using mass spectrometry.Single and multiple factor analyses were conducted to investigate the possible in-fluencing factors of adverse pregnancy outcomes in patients with gestational hypertension.Results After follow-up,it was found that 19 out of 71 patients with gestational hypertension had poor pregnancy outcomes,while 52 had good pregnancy outcomes.The univariate results showed that the prognosis of patients with gestational hypertension was not related to age,pregnancy and childbirth history,family history of hypertension,adverse pregnancy history,high-sensitivity C-reactive pro-tein(hs-CRP),D-dimer(D-D),vitamin D,and total bilirubin,and the differences were not statistically significant(P＞0.05).Compared with pre-pregnancy body mass index(BMI),severity of the condition,blood uric acid,24-hour urine pro-tein quantification,vitamin A,and vitamin E,the differences were statistically significant(P＜0.05).The results of multiple logistic regression indicate that pre-pregnancy BMI(β=1.213,OR=3.582,95％CI=2.482-6.313),severity of the condition(β=1.563,OR=6.413,95％CI=5.682-8.452),blood uric acid(β=1.456,OR=4.083,95％CI=3.235-4.572),24-hour urine protein quantification(β=2.938,OR=1.434,95％CI=1.283-4.394),vitamin A(β=1.691,OR=1.593,95％CI=1.241-1.786),vitamin E(β=1.336,OR=1.246,95％CI=1.187-1.583)were independent risk factors for poor prognosis in patients with gestational hypertension,and the differences were statistically significant(P＜0.05).Conclusion The levels of vitamin A,D,and E are abnormally expressed in patients with gestational hypertension,and their expression levels can reflect the severity of the disease.Adverse pregnancy outcomes in patients are influenced by multiple factors,and different factors can interact and intervene.Therefore,interventions should be targeted at the controllable factors mentioned above.
基金项目
广东省东莞市社会发展科技项目(20211800903722)
维普
万方数据