Williams Keith P, Galerneau France
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT, USA.
J Obstet Gynaecol Can. 2002 Aug;24(8):628-32. doi: 10.1016/s1701-2163(16)30193-1.
To examine whether an elevated serum uric acid level in hypertensive pregnant women is a useful prognostic indicator of severe hypertension; hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome; and small for gestational age (SGA) infants.
A total of 459 women newly diagnosed with hypertension in pregnancy were categorized into "gestational hypertension" and "hypertension with proteinuria (preeclampsia)" groups. Their serum uric acid levels were correlated with the development of HELLP syndrome, severity of hypertension, and incidence of SGA newborns (< 10th percentile birth weight). HELLP syndrome was divided into 3 classes depending on the severity of the thrombocytopenia. Prior to this study, serum uric acid levels had been measured in a group of normotensive women. Mean and standard deviation of serum uric acid levels for each group were compared using analysis of variance and student t-tests, where necessary.
Significant elevation in serum uric acid levels over normotensive pregnant women (285 +/- 72 micromol/L) was observed in both the gestational hypertensive group (341 +/- 83 micromol/L) and the preeclamptic group (384 +/- 93 micromol/L) of women (p < 0.001 and p < 0.05 respectively). Serum uric acid levels were also significantly elevated (p < 0.001) in women with gestational hypertension with HELLP syndrome (382 +/- 78 micromol/L) compared to those without HELLP syndrome (330 +/- 80 micromol/L). Preeclamptic women with HELLP syndrome (412 +/- 99 micromol/L) also demonstrated elevated uric acid levels (p < 0.05) over those without HELLP syndrome (374 +/- 87 micromol/L). However, the level of uric acid did not predict the severity of HELLP syndrome. The presence of SGA infants in the gestational hypertensive group was not associated with increased uric acid levels.
Uric acid levels, although significantly elevated in women with gestational hypertension and preeclampsia as compared to normotensive pregnant women, are not good prognostic indicators of the severity of the maternal or fetal complications.
探讨高血压孕妇血清尿酸水平升高是否是重度高血压、溶血、肝酶升高及血小板减少（HELLP）综合征和小于胎龄（SGA）儿的有效预后指标。
将459例新诊断为妊娠期高血压的孕妇分为“妊娠期高血压”组和“蛋白尿性高血压（先兆子痫）”组。将她们的血清尿酸水平与HELLP综合征的发生、高血压的严重程度以及SGA新生儿（出生体重低于第10百分位数）的发生率进行关联分析。根据血小板减少的严重程度，将HELLP综合征分为3类。在本研究之前，已对一组血压正常的女性测量了血清尿酸水平。必要时，使用方差分析和学生t检验比较每组血清尿酸水平的均值和标准差。
妊娠期高血压组（341±83μmol/L）和先兆子痫组（384±93μmol/L）女性的血清尿酸水平均显著高于血压正常的孕妇（285±72μmol/L）（分别为p<0.001和p<0.05）。与无HELLP综合征的妊娠期高血压女性（330±80μmol/L）相比，患有HELLP综合征的妊娠期高血压女性（382±78μmol/L）的血清尿酸水平也显著升高（p<0.001）。患有HELLP综合征的先兆子痫女性（412±99μmol/L）的尿酸水平也高于无HELLP综合征的女性（374±87μmol/L）（p<0.05）。然而，尿酸水平并不能预测HELLP综合征的严重程度。妊娠期高血压组中SGA婴儿的存在与尿酸水平升高无关。
与血压正常的孕妇相比，妊娠期高血压和先兆子痫女性的尿酸水平虽显著升高，但并非母婴并发症严重程度的良好预后指标。
