Comparative study on clinical characteristics and TyG index in patients with premature preeclampsia and chronic hypertension complicated with preeclampsia

doi:10.11958/20220717

Abstract

Abstract:

Objective To study the clinical characteristics and perinatal outcomes of patients with premature preeclampsia (PE) and chronic hypertension complicated with PE, and to compare the difference of triglyceride-glucose index (TyG) between the two groups of patients. Methods A total of 158 cases of pregnancy terminated by cesarean section at 28-36⁺⁶ weeks of gestation due to "preeclampsia" were selected. According to whether they had chronic hypertension, patients were divided into the chronic hypertension PE group (53 cases) and the PE group (105 cases). The general data, blood routine, coagulation routine, biochemical indexes and TyG were compared between the two groups, and the difference in perinatal outcomes was analyzed. Results Compared with the PE group, patients in the chronic hypertension PE group had older age, higher gestational weight gain during pregnancy, and the gestational age of delivery is earlier, and the difference between the two groups was statistically significant (P<0.05). Data of hematocrit, platelet, fibrinogen, creatine kinase isoenzyme, aspartate aminotransferase, total cholesterol, triglyceride, fasting blood glucose and 24-hour urinary protein were significantly increased in the chronic hypertension PE group, while uric acid was lower (P<0.05). TyG index was also higher in the chronic hypertension PE group (9.89±0.30 vs. 9.76±0.26, P<0.01). The neonatal birth weight and 1-minute Apgar score were lower in the chronic hypertension PE group, but the arterial blood alkaloid surplus was higher and the length of hospital stay in NICU was longer (P<0.05). For both types of preterm PE, the preterm delivery near term (34-36⁺⁶weeks of gestation) accounted for the largest proportion, but the early preterm birth (28-31⁺⁶weeks of gestation) was higher in the chronic hypertension PE group (28.3% vs. 10.5%, P<0.01), and the proportion of small-gestational age babies (SGA) was also higher (60.4% vs. 42.9%，P<0.05). Conclusion Compared with preterm PE, patients with preterm chronic hypertension PE have more significant insulin resistance, hypercoagulability, myocardial and kidney damage, and higher risk of early preterm delivery and SGA. Maternal and fetal monitoring should be more intensive.

Key words: eclampsia, hypertension, premature birth, preeclampsia, TyG index

CLC Number:

R714.252

Figures/Tables 3

References 14

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组别	n	年龄（岁）	孕次（次）	产次（次）	基础BMI（kg/m²）	孕期增重（kg）	分娩孕周（周）
PE组	105	28.49±3.54	2（1，3）	0（0，1）	26.13±4.67	13.73±2.09	34.09±1.89
慢性高血压PE组	53	35.75±3.68	2（1，3）	0.5（0，1）	25.97±4.08	15.09±3.79	33.25±2.27
t或Z		12.024^＊＊	5.746^＊＊	6.089^＊＊	0.220	2.432^＊	2.316^＊

组别	n	年龄（岁）	孕次（次）	产次（次）	基础BMI（kg/m²）	孕期增重（kg）	分娩孕周（周）
PE组	105	28.49±3.54	2（1，3）	0（0，1）	26.13±4.67	13.73±2.09	34.09±1.89
慢性高血压PE组	53	35.75±3.68	2（1，3）	0.5（0，1）	25.97±4.08	15.09±3.79	33.25±2.27
t或Z		12.024^＊＊	5.746^＊＊	6.089^＊＊	0.220	2.432^＊	2.316^＊

组别		n	Hb（g/L）		HCT		PLT（×10⁹/L）		Fbg（g/L）		ALB（g/L）		ALT（U/L）		AST（U/L）		CKMB（U/L）
PE组		105	124.76±12.39		0.37±0.04		210.26±73.60		4.09±0.75		30.42±10.51		22.00（15.60，33.25）		24.20（18.85，31.20）		171.85±82.72
慢性高血压PE组		53	127.96±12.53		0.39±0.04		252.13±93.43		4.30±0.50		29.00±5.25		23.10（16.22，33.20）		25.95（20.30，33.75）		224.15±89.22
t			1.527		1.990^＊		2.847^＊＊		2.147^＊		0.924		1.533		2.881^＊		3.654^＊＊
组别	HbAlc（%）			UA（μmol/L）		BUN（mmol/L）		Cr（μmol/L）		24 h尿蛋白（g）		TC（mmol/L）		TG（mmol/L）		FPG（mmol/L）		TyG指数
PE组	5.86±0.64			434.24±122.73		4.88±2.03		65.26±33.62		5.49（3.09，6.31）		6.89±1.10		4.03±1.00		5.59±0.46		9.76±0.26
慢性高血压PE组	5.92±0.54			396.39±79.64		5.32±2.61		73.05±44.86		5.60（3.57，6.36）		7.68±1.77		4.48±1.21		5.77±0.39		9.89±0.30
t或Z	0.629			2.037^＊		1.149		1.225		1.985^＊		2.961^＊＊		2.491^＊		2.421^＊		2.887^＊＊

组别		n	Hb（g/L）		HCT		PLT（×10⁹/L）		Fbg（g/L）		ALB（g/L）		ALT（U/L）		AST（U/L）		CKMB（U/L）
PE组		105	124.76±12.39		0.37±0.04		210.26±73.60		4.09±0.75		30.42±10.51		22.00（15.60，33.25）		24.20（18.85，31.20）		171.85±82.72
慢性高血压PE组		53	127.96±12.53		0.39±0.04		252.13±93.43		4.30±0.50		29.00±5.25		23.10（16.22，33.20）		25.95（20.30，33.75）		224.15±89.22
t			1.527		1.990^＊		2.847^＊＊		2.147^＊		0.924		1.533		2.881^＊		3.654^＊＊
组别	HbAlc（%）			UA（μmol/L）		BUN（mmol/L）		Cr（μmol/L）		24 h尿蛋白（g）		TC（mmol/L）		TG（mmol/L）		FPG（mmol/L）		TyG指数
PE组	5.86±0.64			434.24±122.73		4.88±2.03		65.26±33.62		5.49（3.09，6.31）		6.89±1.10		4.03±1.00		5.59±0.46		9.76±0.26
慢性高血压PE组	5.92±0.54			396.39±79.64		5.32±2.61		73.05±44.86		5.60（3.57，6.36）		7.68±1.77		4.48±1.21		5.77±0.39		9.89±0.30
t或Z	0.629			2.037^＊		1.149		1.225		1.985^＊		2.961^＊＊		2.491^＊		2.421^＊		2.887^＊＊

组别		n	出生体质量（g）			1分钟Apgar（分）		pH		BE（mmol/L）		LAC（mmol/L）
PE组		105	1 961.27±475.59			7.89±1.70		7.26±0.09		-5.77±2.94		3.90（3.05，5.55）
慢性高血压PE组		53	1 710.75±459.87			7.32±1.52		7.23±0.10		-6.99±3.81		3.90（3.08，5.93）
t、Z或χ²			3.161^＊＊			2.048^＊		1.721		2.208^＊		1.431
组别	分娩孕周						新生儿分类						住NICU时间（d）
组别	孕28~31⁺⁶周			孕32~33⁺⁶周	孕34~36⁺⁶周		适于胎龄儿（AGA）		大于胎龄儿（LGA）		小于胎龄儿（SGA）		住NICU时间（d）
PE组	11（10.5）			26（24.8）	68（64.8）		59（56.2）		1（1.0）		45（42.9）		10（7，17）
慢性高血压PE组	15（28.3）			14（26.4）	24（45.3）		21（39.6）		0		32（60.4）		11（7，18）
t、Z或χ²	9.134^＊						4.633^＊						3.000^＊＊