蛋白尿和尿酸水平升高与子痫危象相关。

Increased proteinuria and uric acid levels are associated with eclamptic crisis.

作者信息

Paula Leticia G, Pinheiro da Costa Bartira E, Hentschke Marta R, Antonello Ivan C, Luz Jorge H, da Cunha Filho Edson V, Poli-de-Figueiredo Carlos E

机构信息

Programa de Pós-Graduação em Medicina e Ciências da Saúde, São Lucas Hospital, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil.

出版信息

Pregnancy Hypertens. 2019 Jan;15:93-97. doi: 10.1016/j.preghy.2018.12.003. Epub 2018 Dec 10.

DOI:10.1016/j.preghy.2018.12.003

PMID:30825934

Abstract

OBJECTIVES

Eclampsia results in high morbidity and mortality, so it is important to identify clinical and laboratorial aspects that may be useful as potential markers to differentiate women at higher risk. Thus, we aim to identify, among women with preeclampsia, aspects that may increase the risk to develop eclampsia.

STUDY DESIGN

Retrospective cohort study. The records of patients delivered at Hospital São Lucas/PUCRS were reviewed retrospectively; 733 pregnant women with hypertension were analyzed; 329 had preeclampsia, and 45 eclampsia.

MAIN OUTCOME MEASURES

Serum uric acid levels and protein excretion in women that develop eclampsia.

RESULTS

Patients with eclampsia had higher serum uric acid levels and protein excretion, systolic and diastolic blood pressure; were more likely to have cesarean section and had worst perinatal outcomes. The combination of uric acid above 5.9 mg/dL and protein/creatinine ratio over 4.9 had a striking association with eclampsia (p ≤ 0.001). The occurrence of HELLP syndrome was significantly different between groups, with a higher incidence among women who developed eclampsia (OR 6.5; 95%CI, 3.2-13.2; p < 0.001).

CONCLUSION

Our data suggest that the combination of high levels of maternal serum uric acid and proteinuria are strongly associated with the development of eclamptic crises.

摘要

目的

子痫会导致高发病率和死亡率，因此识别可能有助于区分高危女性的临床和实验室指标很重要。因此，我们旨在识别子痫前期女性中可能增加发生子痫风险的因素。

研究设计

回顾性队列研究。对圣卢卡斯医院/PUCRS分娩的患者记录进行回顾性分析；分析了733例高血压孕妇；其中329例患有子痫前期，45例患有子痫。

主要观察指标

发生子痫的女性的血清尿酸水平和蛋白质排泄情况。

结果

子痫患者的血清尿酸水平、蛋白质排泄量、收缩压和舒张压更高；更有可能进行剖宫产，围产期结局更差。尿酸水平高于5.9mg/dL且蛋白质/肌酐比值超过4.9与子痫有显著关联（p≤0.001）。两组间HELLP综合征的发生率有显著差异，子痫患者的发生率更高（比值比6.5；95%置信区间，3.2 - 13.2；p<0.001）。