标题：妊娠期高血压疾病患者血清NT-proBNP、ET-1、NO水平及其临床意义

      作者：邓勇钢 1，刘念 2，谢芸芸 1    上海市浦东新区人民医院检验科 1、妇产科 2 上海 201299

      卷次： 2020年31卷5期

      【摘要】 目的 探讨妊娠期高血压疾病患者血清N末端-脑钠肽前体(NT-proBNP)、内皮素-1 (ET-1)、一氧化氮(NO)水平及其临床意义。方法 选取上海市浦东新区人民医院2016年11月至2018年5月收治的妊娠期高血压疾病患者147例，根据其分型分为妊娠期高血压组84例和子痫前期组63例，另选取同期正常妊娠孕产妇60例作为对照组。采用电化学发光免疫法检测血清NT-proBNP水平，采用酶联免疫吸附法检测血清ET-1水平，采用硝酸还原酶法检测血清NO水平，采用超声检测仪检测三组孕妇左心室功能参数和肾血流动力学指标，对上述检测指标进行比较。采用Pearson法分析妊娠期高血压疾病患者血清NT-proBNP、ET-1、NO水平与左心室功能参数、肾血流动力学指标的相关性。结果 对照组、妊娠期高血压组、子痫前期组孕妇的血清NT-proBNP、ET-1水平逐渐升高，而NO水平逐渐降低，差异均有统计学意义(P<0.05)；对照组、妊娠期高血压组、子痫前期组孕妇的二尖瓣舒张晚期充盈速度比值(E/A)逐渐下降，而二尖瓣舒张早期血流速度峰值与二尖瓣环舒张早期运动速度峰值的比值(E/Ea)逐渐上升，差异均有统计学意义(P<0.05)；与对照组和妊娠期高血压组孕妇比较，子痫前期组孕妇的舒张末期流速(EDV)降低，而搏动指数(PI)、阻力指数(RI)、收缩/舒张期速度比(S/D)升高，差异均有统计学意义(P<0.05)；Pearson法分析结果显示，妊娠期高血压疾病患者血清NT-proBNP、ET-1水平与E/Ea、PI、RI、S/D呈正相关(P<0.05)，而与E/A、EDV呈负相关(P<0.05)；血清NO水平与 E/Ea、PI、RI、S/D呈负相关(P<0.05)，而与 E/A、EDV呈正相关(P<0.05)。结论 不同分型妊娠期高血压疾病患者血清NT-proBNP、ET-1、NO水平存在一定差异，且三者与患者左心室功能参数和肾血流动力学指标密切相关，其可以用于辅助判断妊娠期高血压疾病患者病情。
      【关键词】 妊娠期高血压疾病；N末端-脑钠肽前体；内皮素-1；一氧化氮；左心室功能；肾血流动力学
      【中图分类号】 R714.24+6 【文献标识码】 A 【文章编号】 1003—6350（2020）05—0566—05

Serum levels and clinical significance of NT-proBNP, ET-1, NO in patients with pregnancy-inducedhypertension.
DENG Yong-gang 1, LIU Nian 2, XIE Yun-yun 1. Department of Clinical Laboratory 1, Department ofObstetrics and Gynecology 2, Shanghai Pudong New District People's Hospital, Shanghai 201299, CHINA
【Abstract】 Objective To investigate serum levels and clinical significance of N-terminal pro-brain natriuret-ic peptide (NT-proBNP), endothelin-1 (ET-1), nitric oxide (NO) in patients with pregnancy-induced hypertension.Methods A total of 147 patients with pregnancy-induced hypertension, who admitted to Shanghai Pudong New Dis-trict People's Hospital from November 2016 to May 2018 were selected and divided into the pregnancy hypertensiongroup (n=84) and preeclampsia group (n=63) according to their classification. During the same time, 60 normal pregnantwomen were selected as the control group. Serum NT-proBNP level was detected by electrochemiluminescence immuno-assay; serum ET-1 level was detected by enzyme-linked immunosorbent assay (ELISA); serum NO level was detectedby nitrate reductase method; the parameters of left ventricular function and renal hemodynamics parameters in threegroups of pregnant women were detected by ultrasonic detector; the above detection indexes in the three groups werewell compared. Pearson method was used to analyze the correlation of serum NT-proBNP, ET-1, NO levels with leftventricular function parameters and renal hemodynamics parameters in patients with pregnancy-induced hypertension.Results Serum NT-proBNP and ET-1 levels of pregnant women in the control group, pregnancy hypertension group,and preeclampsia group increased gradually, while NO levels decreased gradually; the differences were statistically sig-nificant (all P<0.05). The ratio of late diastolic filling velocity of mitral valve (E/A) of pregnant women in the controlgroup, pregnancy hypertension group, and preeclampsia group decreased gradually, while the ratio of peak blood flowvelocity in early diastole to peak motion velocity in early diastole of mitral annulus (E/Ea) increased gradually; the differ-ences were statistically significant (all P<0.05). Compared with the pregnant women in the control group and pregnancyhypertension group, the end-diastolic flow velocity (EDV) in the pregnant women of the preeclampsia group decreased,while the pulsation index (PI), resistance index (RI), systolic/diastolic velocity ratio (S/D) increased; the differenceswere statistically significant (all P<0.05). Pearson analysis showed that serum NT-proBNP and ET-1 levels were posi-tively correlated with E/Ea, PI, RI and S/D in patients with pregnancy-induced hypertension (all P<0.05), but they were