24 h动态血压监测联合血清NT-proBNP、T-cadherin 水平对子痫前期孕妇围生期结局的预测价值.

Objective To investigate the predictive value of 24 h ambulatory blood pressure monitoring combined with serum N-terminal B-type brain natriuretic peptide precursor （NT-proBNP） and T-cadherin levels for perinatal outcome of pregnant women with preeclampsia （PE）. Methods A total of 196 PE pregnant women were selected and divided into the poor perinatal outcome group （128 cases） and good perinatal outcome group （68 cases） according to the perinatal outcome. All pregnant women received 24 h ambulatory blood pressure monitoring on the next day after admission； we collected peripheral venous blood， centrifuged serum， and tested serum NT-proBNP， T-cadherin. The 24 h ambulatory blood pressure parameters and serum NT-proBNP and T-cadherin levels were compared between the two groups. Multivariate Logistic regression model was used to analyze the influencing factors for poor perinatal outcome of PE pregnant women. The predictive value of 24 h ambulatory blood pressure parameters and serum NT-proBNP and T-cadherin levels for the adverse perinatal outcome of PE pregnant women was analyzed by using the receiver operating characteristic （ROC） curve. Results The 24 h， daytime and nighttime systolic blood pressure （SBP） and its load value，24 h， daytime and nighttime diastolic blood pressure （DBP） and its load value， as well as the serum NT-proBNP water in the poor outcome group were significantly higher than those in the good outcome group （all P<0. 05）， while the serum T-cadherin level was significantly lower than that in the good outcome group （P<0. 05）. Multivariate Logistic regression analysis showed that nighttime SBP load value， severe PE and serum NT-proBNP level were independent risk factors for poor perinatal outcome of PE pregnant women， while serum T-cadherin level was its independent protective factor （all P<0. 05）. The ROC curve analysis showed that the area under the curve of nighttime SBP load value and serum NT-proBNP and T-cadherin levels alone and jointly in predicting the poor perinatal outcome of PE pregnant women was 0. 759，0. 666，0. 687 and 0. 921， respectively. The area under the curve of nighttime SBP load value and serum NT-proBNP and T-cadherin levels combined in predicting the poor perinatal outcome of PE pregnant women was significantly higher than that of the three alone （P< 0. 05）. Conclusion The nighttime SBP load value and serum NT-proBNP level of PE pregnant women with poor perina⁃ tal outcomes significantly increase， while the serum T-cadherin level significantly decreases； the nighttime SBP load value and serum NT-proBNP and T-cadherin levels have certain predictive value for the adverse perinatal outcome of PE pregnant women， and the combined predictive value of the three is higher. [ABSTRACT FROM AUTHOR]