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子痫前期和子痫患者血清乳酸脱氢酶及尿酸的研究:它们能否预测不良母婴结局?

A Study on Serum Lactate Dehydrogenase and Uric Acid in Preeclampsia and Eclampsia: Can they Predict Adverse Fetomaternal Outcome?

作者信息

Moharana Jayashree Jayabharati, Mishra Ruchi, Nayak Ajit Kumar

机构信息

Department of Obstetrics and Gynecology, SCB Medical College and Hospital, Cuttack, Odisha, India.

出版信息

Int J Appl Basic Med Res. 2023 Apr-Jun;13(2):95-100. doi: 10.4103/ijabmr.ijabmr_626_22. Epub 2023 Jul 17.

DOI:10.4103/ijabmr.ijabmr_626_22
PMID:37614835
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10443457/
Abstract

BACKGROUND

Hypertensive disorders of pregnancy affect 3%-5% of all pregnancies, contributing immensely to maternal morbidity and mortality. According to the WHO, the incidence of deaths due to preeclampsia and eclampsia in developing and developed countries is 2.8% and 0.4%, respectively. Lactate dehydrogenase (LDH) and uric acid are good predictors of disease severity.

AIM

This study aims to determine the fetomaternal outcome in relation to abnormal serum levels of LDH and uric acid.

MATERIALS AND METHODS

A cross-sectional study was carried out in 1200 patients with preeclampsia and eclampsia at a tertiary care center over 2 years. Patients were divided into - Group A: patients with normal LDH (≤300 IU/L) and uric acid (<6 mg/dl) ( = 300). Group B: patients with abnormal LDH and uric acid ( = 900), who were further divided into mild and severe preeclampsia and eclampsia. Abnormal serum values were stratified into groups for easier comparison. The results were compared in terms of maternal and perinatal outcomes.

RESULTS

The incidence of preeclampsia and eclampsia in our study is 3.14% and 1.57%, respectively. Significant changes in LDH and uric acid were associated with increased severity of the disease (LDH - 1116.94 ± 4.78; uric acid - 9.2 ± 2.89). Higher incidence of maternal and fetal complications was seen with severe preeclampsia and eclampsia with LDH >800 IU/L and uric acid >6 mg/dl.

CONCLUSION

Standard antenatal follow-up should be carried out for early detection and prevention of preeclampsia, with strict monitoring of serum uric acid level and LDH. This may reduce the maternal and fetal complications due to preeclampsia.

摘要

背景

妊娠高血压疾病影响3% - 5%的所有妊娠,对孕产妇发病率和死亡率有极大影响。据世界卫生组织称,发展中国家和发达国家因先兆子痫和子痫导致的死亡率分别为2.8%和0.4%。乳酸脱氢酶(LDH)和尿酸是疾病严重程度的良好预测指标。

目的

本研究旨在确定与血清LDH和尿酸水平异常相关的母婴结局。

材料与方法

在一家三级护理中心对1200例先兆子痫和子痫患者进行了为期2年的横断面研究。患者分为 - A组:LDH正常(≤300 IU/L)且尿酸正常(<6 mg/dl)(n = 300)。B组:LDH和尿酸异常(n = 900),进一步分为轻度和重度先兆子痫及子痫。将异常血清值分层分组以便于比较。比较了母婴结局方面的结果。

结果

我们研究中先兆子痫和子痫的发病率分别为3.14%和1.57%。LDH和尿酸的显著变化与疾病严重程度增加相关(LDH - 1116.94 ± 4.78;尿酸 - 9.2 ± 2.89)。LDH >800 IU/L且尿酸 >6 mg/dl的重度先兆子痫和子痫患者出现母婴并发症的发生率更高。

结论

应进行标准的产前随访以早期发现和预防先兆子痫,严格监测血清尿酸水平和LDH。这可能减少因先兆子痫导致的母婴并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8f/10443457/1f91e7bac18c/IJABMR-13-95-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8f/10443457/66e3516b5749/IJABMR-13-95-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8f/10443457/1f91e7bac18c/IJABMR-13-95-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8f/10443457/66e3516b5749/IJABMR-13-95-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e8f/10443457/1f91e7bac18c/IJABMR-13-95-g002.jpg

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Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy.妊娠期高血压。美国妇产科医师学会妊娠期高血压特别工作组报告
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Global and regional estimates of preeclampsia and eclampsia: a systematic review.
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