妊娠期高血压疾病患者血清AngⅡ、ALD、PFKFB3水平变化及与妊娠结局的关系OA

Objective To study the changes in serum angiotensin Ⅱ(Ang Ⅱ),aldosterone(ALD)and 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3(PFKFB3)levels in patients with hypertensive disorders of pregnancy(HDP)and their relationship with pregnancy outcomes.Methods A total of 156 patients with HDP in the Obstetrics Department,Sichuan Provincial Maternal and Child Health Hospital from July 2023 to June 2025 were selected as the research group,and 156 normal pregnant women who came to the hospital for prenatal examination during the same period were selected as the control group.General data such as age,body mass index,gestational age,number of pregnancies,number of deliveries,and type of parturient(primiparas/multiparas)of the research group and the control group were collected.General data such as disease severity,24-hour urine total protein(24 h UTP),systolic blood pressure(SBP),and diastolic blood pressure(DBP)of the research group were collected.The serum Ang Ⅱ,ALD and PFKFB3 were measured in the research group on the day after admission,and in the control group on the day of prenatal examination.The patients in the research group were divided into the gestational hypertension group(n=97),the mild preeclampsia(PE)group(n=40),and the severe PE group(n=19)according to the severity of the disease.According to the pregnancy outcomes,they were divided into the good pregnancy outcome group(n=119)and the adverse pregnancy outcome group(n=37).The levels of serum Ang Ⅱ,ALD and PFKFB3 in the research group and the control group were compared.The levels of serum Ang Ⅱ,ALD and PFKFB3 in the gestational hypertension group,mild PE group and severe PE group were also compared.In addition,the value of serum Ang,ALD and PFKFB3 alone and in combination in the diagnosis of HDP was analyzed.Logistic regression was used to analyze the influencing factors of adverse pregnancy outcomes in patients with HDP.Results The serum Ang Ⅱand ALD in the research group were lower than those in the control group,and the serum PFKFB3 was higher than that in the control group(P<0.05).The levels of serum Ang Ⅱ and ALD in the gestational hypertension group were higher than those in the mild PE group and the severe PE group,while the level of serum PFKFB3 was lower than that in the mild PE group and the severe PE group(P<0.05).The serum Ang Ⅱ and ALD in the mild PE group were higher than those in the severe PE group,and the serum PFKFB3 was lower than that in the severe PE group(P<0.05).The diagnostic value of the combined diagnosis of HDP by serum Ang Ⅱ,ALD and PFKFB3 was higher than that of the individual diagnosis of the three(P<0.05).Logistic regression analysis showed that disease severity,24 h UTP,SBP,DBP,and PFKFB3 were all risk factors for adverse pregnancy outcomes in HDP,while Ang Ⅱ and ALD were protective factors for adverse pregnancy outcomes(P<0.05).Conclusion The levels of serum Ang Ⅱ and ALD in patients with HDP are lower than those in normal pregnant women,and the level of serum PFKFB3 is higher than that in normal pregnant women.The combined diagnosis of the three has a relatively high diagnostic efficacy for HDP.Among them,Ang Ⅱ and ALD are protective factors for adverse pregnancy outcomes in HDP patients,while PFKFB3 is a risk factor for adverse pregnancy outcomes in patients with HDP.