单核细胞/淋巴细胞比值与妊娠期高血压疾病严重程度的相关性研究

吴晶 傅广

【摘要】目的：探讨单核细胞/淋巴细胞比值（MLR）与妊娠期高血压疾病（HDP）严重程度的相关性。方法：连续收集2017年1月至2020年1月在南华大学附属长沙医院住院的妊娠期高血压疾病患者172例，按疾病严重程度分为：妊娠期高血压组（81例）、轻度子痫前期组（51例）、重度子痫前期组（40例），同时选取同期在南华大学附属长沙医院住院的無高血压的健康单胎妊娠孕妇为正常妊娠组（122例）。记录所有研究对象一般资料和生化指标。结果：通过单因素方差分析及LSD- t 检验两两比较分析显示， HDP组单核细胞计数（MONO）与MLR显著高于正常妊娠组（P<0.05），子痫前期组MLR高，于妊娠期高血压组，又高于正常妊娠组; Pearson相关性分析显示MLR与SBP、DBP、24 h-UTP呈正相关关系（P<0.05）。由受试者工作曲线（ROC）得出MLR的曲线下面积为0.347（95%CI 0.285～0.409）<0.5。结论：与正常妊娠妇女相比， HDP患者MLR及MONO明显增高， HDP患者血压越高，24h-UTP越多，即HDP越严重， MLR增高越明显; MLR可能是临床作为识别HDP严重程度的一个简单、无创、医疗成本低的实验室指标。

【关键词】单核细胞/淋巴细胞比值;妊娠期高血压疾病;收缩压;舒张压;24小时尿蛋白定量

【中图分类号】R714.1 R714.2【文献标识码】A 【文章编号】2096-5249（2021）22-0019-04

The research about correlation of monocyte to lymphocyte ratio with the severity of hypertensive disorders of pregnancy

Wu Jing Fu Guang

Changsha Hospital A?liated to Nanhua University， Changsha 410005， China

【Abstract】Objective：To explore the relationship between the monocyte to lymphocyle ratio（MLR）and the severity of hy- pertensive disorders of pregnancy（HDP）.Methods：Continuous collection of 172 HDP patients in Changsha Hospital A?liated to Nanhua University from January 2017 to January 2020 were selected as hypertensive disorders ofpregnancy group（HDP group，172 cases）.According to the severity of the disease，it can be divided into：The hypertension during pregnancy group（81 cases），the mild preeclampsia group（51 cases），and the preeclampsia severe group（40 cases）. At the same time，healthy singleton pregnancy women without high blood pressure in in Changsha Hospital A?liated to Nanhua University during the same period were selected as the normal pregnancy group（122 cases），and the general data and biochemicalindicators of all research subjects were recorded. Results：Through one-way analysis of variance and LSD-t test pairwise comparison analysis showed that the monocyte count and MLR of the HDP group were signi?cantly higher than those ofthe normal pregnancy group，and the MLR ofthe preeclampsia group was higher than that of the hypertension group during pregnancy，and higher than that of the normal pregnancy group，pearson correlation analysis shows that MLR was positively correlated with SBP、DBP、and 24 h-UTP.Conclusion：Compared with normal pregnancy women，the MLR and MONO of HDP patients has signi?cantly increased，and the higher the blood pressure，the more 24h-UTP，the more severe the HDP，and the more obvious the increase in MLR;MLR may be a simple，non-inasive，and low-cost laboratory indicator forclinically identifying the severity of HDP.

【Keywords】Monocyte to lymphocyle ratio;Gestational hypertension;Systolic blood pressure;Diastolic blood pressure;24-hour urine protein quanti?cation

妊娠期高血压疾病（HDP）为发生于妊娠期的常见疾病，我国的发病率约为10%，据世界卫生组织（World Health Organization，WHO）统计，全球因 HDP所致孕产妇死亡率占妊娠相关死亡总数的10%～16%[1]，严重影响母婴健康，是造成孕产妇和围产儿死亡的主要原因之一[2]。而该病可呈一个逐渐进展的过程，任何形式的HDP都有造成母婴结局预后差，因此，及时、准确的判断HDP 的病情严重程度，以便于及时合理干預，避免不良妊娠结局发生，对改善孕产妇及围产儿发病率和死亡率具有重要意义。目前， HDP 的严重程度主要依据血压、蛋白尿及是否存在子痫来识别，尚缺乏良好的生化指标。本研究重点在于探讨单核细胞/淋巴细胞比值（monocyte to lymphocyle ratio，MLR）与 HDP严重程度的相关性，目的是为临床识别HDP严重程度提供简单实用、无创、医疗成本低的实验室指标。……