重度子痫前期患者血清脑源性神经营养因子水平及影响围产儿结局的因素分析

摘要

Objective:To study the serum brain derived neurotrophic factor(BDNF) levels in severe pre-eclampsia patients and influencing factors of perinatal outcomes.Method:A total of 120 cases of severe pre-eclampsia admitted by Shajing People's Hospital from February 2016 to February 2018 were selected.The perinatal outcomes were analyzed,the levels of serum BDNF and neuron specific enolase(NSE) in patients with different outcomes were analyzed,the influencing factors of adverse perinatal outcomes were analyzed. Result:The incidence of adverse perinatal outcomes in severe pre-eclampsia was 38.33%,included low birth weight(15.83%),neonatal disease(10.83%),perinatal asphyxia(5.83%),birth defects(4.17%) and perinatal death(1.67%).The serum BDNF level in poor outcome group was higher than that of good outcome group,the level of NSE was lower than that of good outcome group,the differences were statistically significant(P<0.05).The birth gestational age,irregular obstetric examination,placental abruption,history of pre-eclampsia and fetal growth restriction was associated with severe preeclampsia poor perinatal outcomes (P<0.05).Multivariate logistic regression analysis showed that gestational weeks,irregular obstetric examination and placental abruption were all the factors influencing the outcome of severe preeclampsia(P<0.05). Conclusion:The serum levels of BDNF and NSE in patients with severe pre-eclampsia were correlated with perinatal outcomes,which could be used as clinical predictors of adverse perinatal outcomes,and the gestational age of delivery,irregular obstetric examination and placental abruption are all the influencing factors of adverse perinatal outcomes of severe pre-eclampsia,which deserve clinical attention.%目的:研究重度子痫前期患者血清脑源性神经营养因子(BDNF)水平及影响围产儿结局的因素.方法:选取2016年2月-2018年2月沙井人民医院收治的重度子痫前期患者120例,统计围产儿结局情况,分析不同结局患者血清BDNF、神经元特异性烯醇化酶(NSE)水平,分析围产儿结局不良的影响因素.结果:重度子痫前期围产儿不良结局发生率为38.33%,主要包括低出生体质量15.83%、新生儿疾病10.83%、围产儿窒息5.83%、出生缺陷4.17%、围产儿死亡1.67%;结局不良组血清BDNF水平低于结局良好组,NSE水平高于结局良好组,比较差异均有统计学意义(P<0.05);分娩孕周、不规律产检、胎盘早剥、子痫前期病史、胎儿生长受限均可能与重度子痫前期围产儿结局不良有关(P<0.05);经多因素Logisitic回归分析可得:分娩孕周、不规律产检以及胎盘早剥均是重度子痫前期围产儿结局不良的影响因素(P<0.05).结论:重度子痫前期患者血清BDNF、NSE水平均与围产儿结局相关,可作为临床上预测围产儿结局不良的指标;且分娩孕周、不规律产检及胎盘早剥均是重度子痫前期围产儿结局不良的影响因素,值得临床重点关注.