Penn Cardiovascular Institute, Philadelphia, Pennsylvania, USA.
Am J Perinatol. 2010 Apr;27(4):313-9. doi: 10.1055/s-0029-1241735. Epub 2009 Oct 24.
We tested the hypothesis that the cardiac biomarker N-terminal pro-brain natriuretic peptide would be elevated in hypertensive disorders of pregnancy, with an increase in levels of this biomarker across increasing gradations of disease severity. We performed a case-controlled study of women admitted to labor and delivery at the Hospital of the University of Pennsylvania between 24 and 42 weeks of gestation. Cases had hypertension that developed after 20 weeks of gestation, and controls were normotensive women presenting for delivery. N-terminal pro-brain natriuretic peptide levels were compared between cases ( N = 83) and controls ( N = 290). Cases were subclassified into gestational hypertension ( N = 20) and mild ( N = 15) and severe preeclampsia ( N = 48), and N-terminal pro-brain natriuretic peptide levels were compared between these subgroups. N-terminal pro-brain natriuretic peptide levels were higher in cases than in controls (81 pg/mL versus 37 pg/mL, P < 0.001), with a graded increase in levels from gestational hypertension (64 pg/mL) to preeclampsia (89 pg/mL) to severe preeclampsia (157 pg/mL; P < 0.001). Each log increase in N-terminal pro-brain natriuretic peptide doubled the risk of preeclampsia (odds ratio = 2.10 P < 0.001). N-terminal pro-brain natriuretic peptide levels were increased in hypertensive disorders of pregnancy and discriminate between subcategories of disease.
我们检验了假设，即心脏生物标志物 N 末端脑利钠肽前体（N-terminal pro-brain natriuretic peptide）在妊娠高血压疾病中会升高，并且随着疾病严重程度的增加，该生物标志物的水平会增加。我们对在宾夕法尼亚大学医院分娩的 24 至 42 孕周的妇女进行了病例对照研究。病例组为妊娠 20 周后发生的高血压，对照组为正常血压的分娩妇女。比较了病例组（N=83）和对照组（N=290）之间的 N 末端脑利钠肽前体水平。病例组进一步分为妊娠期高血压（N=20）、轻度子痫前期（N=15）和重度子痫前期（N=48），并比较了这些亚组之间的 N 末端脑利钠肽前体水平。病例组的 N 末端脑利钠肽前体水平高于对照组（81pg/ml 比 37pg/ml，P<0.001），水平呈梯度升高，从妊娠期高血压（64pg/ml）到子痫前期（89pg/ml）到重度子痫前期（157pg/ml；P<0.001）。N 末端脑利钠肽前体每增加一个对数单位，子痫前期的风险就增加一倍（优势比=2.10，P<0.001）。N 末端脑利钠肽前体在妊娠高血压疾病中升高，并能区分疾病的亚类。
