孕早期血清雌激素水平与妊娠期高血压疾病发病风险的关系研究

摘要 目的：探讨孕早期血清雌二醇（E₂）水平与妊娠期高血压疾病（HDCP）发病风险的关系。方法：选取2021年12月至2022年12月我院收治的100例HDCP患者（HDCP组），另取同期产前检查健康孕妇80例为对照组，根据HDCP分类分为妊娠期高血压组（26例）、子痫前期-子痫组（35例）、妊娠合并慢性高血压组（21例）、慢性高血压伴发子痫前期组（18例）。检测血清E₂水平，比较对比不同妊娠期高血压疾病分类血清E₂水平差异。采用Logistic回归方法分析影响HDCP发病的危险因素。受试者工作特征（ROC）曲线分析血清E2水平预测HDCP的价值。结果：HDCP组血清E₂水平低于对照组（P＜0.05），子痫前期-子痫组血清E2水平低于慢性高血压伴发子痫前期组、妊娠合并慢性高血压组、妊娠期高血压组（P＜0.05），慢性高血压伴发子痫前期组血清E₂水平低于妊娠合并慢性高血压组、妊娠期高血压组（P＜0.05）。年龄≥35岁、高孕前BMI、产次≥2次、高血压家族史、母亲HDCP病史是HDCP发病的危险因素（P＜0.05），E₂是保护因素（P＜0.05）。E₂预测HDCP的临界值为162.35 ng/L，曲线下面积为0.744，灵敏度为79.00%，特异度为76.25%。结论：HDCP患者孕早期血清E₂水平显著降低，且与HDCP病情加重有关，检测E₂水平可预测HDCP风险。

Study on the Relationship between Serum Estrogen Level in Early Pregnancy and the Risk of Hypertensive Disorder Complicating Pregnancy

ABSTRACT Objective: To investigate the relationship between serum estradiol (E₂) level in early pregnancy and the risk of hypertensive disorder complicating pregnancy (HDCP). Methods: 100 HDCP patients (HDCP group) who were admitted to our hospital from December 2021 to December 2022 were selected, and 80 healthy pregnant women who underwent prenatal examination during the same period were selected as control group, patients were divided into gestational hypertension group (26 cases), preeclampsia-eclampsia group (35 cases), pregnancy with chronic hypertension group (21 patients), and chronic hypertension with preeclampsia group (18 patients) according to the HDCP classification. Serum E₂ levels were detected, and the differences of serum E₂ levels in different groups were compared. The risk factors affecting the incidence of HDCP were analyzed by Logistic regression analysis. The value of serum E₂ level in predicting HDCP were analyzed by receiver operating characteristic (ROC) curve. Results: The serum E₂ level in HDCP group was lower than that in control group (P<0.05), The serum E₂ level of the preeclampsia-eclampsia group was lower than that of the chronic hypertension with preeclampsia group, the pregnancy with chronic hypertension group and the pregnancy with hypertension group (P<0.05), and the serum E₂ level of chronic hypertension with preeclampsia group was lower than that of pregnancy with chronic hypertension group and the pregnancy with hypertension group (P<0.05). Age≥35 years old, high pre-pregnancy BMI, parity≥2 times, family history of hypertension, and maternal history of HDCP were risk factors for HDCP(P<0.05), and E₂ was a protective factor (P<0.05). The critical value of E₂ in predicting HDCP was 162.35 ng/L, the area under the curve was 0.744, the sensitivity was 79.00%, and the specificity was 76.25%. Conclusion: The level of serum E₂ in early pregnancy of HDCP patients was significantly decrease, which is relate to the aggravation of HDCP, the detection of E₂ level could predict the risk of HDCP.