Correlation betweeen changes of cardiorenal function and severe preeclampsia
Abstract：Objective To investigate the changes of cardiorenal function of patients with severe preeclampsia or mild preeclampsia.Methods A total of 69 patients with preeclampsia who were treated in our hospital from March 2016 to March 2017 were enrolled in the study. According to the American association of obstetrics and gynecology doctors' gestational hypertension disease guide (2013), these patients were divided into mild preeclampsia group (n = 34) and severe preeclampsia group (n=35). The specimens of empty stomach blood were taken within 24 hours after admission, and the serum levels of interleukin 6 (IL-6), endothelin (ET-1) were tested by enzyme-linked immunosorbent assay. The levels of hypersensitive C-reactive protein (hs-CRP) were detected by the immunoturbidimetry. The levels of nitric oxide (NO) were measured by nitrate reduction process. The levels of plasma amino terminal brain natriuretic peptide precursor(NT-proBNP) were tested by electrochemiluminescence method.Moreover the levels of 24h urine protein and serum inhibition C (Cys-C) were detected by immune projection turbidimetry. In addition the levels of left ventricular ejection fraction (EF) were examined by two-dimensional echocardiography,and the early diastolic blood flow velocity (E) of mitral valve and peak velocity of left atrial late diastolic blood flow (A) were detected by flow Doppler. The peak velocity of mitral annular root velocity(Ea) was measured by tissue Doppler imaging,and the ratios of E/A and E/Ea were calculated. The left ventricular base and apical peak rotation(BRmax,ARmax) were measured by two-dimensional speckle tracking imaging technique(2D-STI),and left ventricular systole Twistmax was calculated. The renal interlobular artery resistance index (RI), pulsation index(PI),systolic peak flow velocity(PSV) and end-diastolic velocity(EDV) were measured by Color Doppler ultrasound. Besides the correlation between E/Ea and Cys-C,NT-proBNP was analyzed by means of Pearson correlation analysis.Results As compared with those in mild preeclampsia group,the 24h urine protein content,serum levels of Cys-C,NT-proBNP,IL-6,hs-CRP,ET-1 were increased in severe preeclampsia group (P<0.05),but the NO levels were decreased (P<0.05).The E/A in severe preeclampsia group was significantly lower than that in mild preeclampsia group,however, the E/Ea ratio was obviously higher,and the levels BRmax, ARmax and Twistmax were increased. Moreover the levels of double kidney RI and PI in severe preeclampsia group were obviously increased,and EDV and PSV were significantly decreased,as compared with those in mild preeclampsia group (P<0.05).In addition the E/Ea was positively correlated with Cys-C,NT-proBNP (r=0.824, 0.845,P<0.05).Conclusion The cardiorenal function is significantly impaired in patients with preeclampsia,especially in patients with severe preeclampsia. There is a correlation between cardiac funcition injury and renal function injury. Monitoring the levels of pro-BNP is conducive to the evaluation of cardiorenal injury degree. Moreover there is correlation between the cardiorenal function injury and the increase of serum inflammatory response levels as well as vascular endothelial function disorder.
Keywords：echocardiographyprecursors of amino terminal natriuretic peptidepreeclampsia
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1032-1035,1038 )