广西医学

目的　探讨血清尿酸/肌酐（SUA/Cr）值与子痫前期（PE）患者不良妊娠结局的相关性。方法　回顾性分析146例PE患者的临床资料。根据患者围产期是否发生不良妊娠结局将其分为妊娠不良组（n=40）和妊娠正常组（n=106）。比较两组患者的临床资料，采用Logistic回归模型分析影响PE患者发生不良妊娠结局的因素。绘制受试者工作特征曲线，采用曲线下面积（AUC）评价独立危险因素对不良妊娠结局的预测价值。采用Spearman相关性分析SUA/Cr值与不良妊娠结局的相关性。结果　（1）妊娠不良组入院时收缩压、舒张压、24 h尿蛋白含量、SUA水平、SUA/Cr值，以及分娩前1周内胎儿脐带血流收缩期峰值流速与舒张期流速的比值（S/D）高于或大于妊娠正常组，入院时血清白蛋白水平低于妊娠正常组（P<0.05）。（2）多因素Logistic回归分析结果显示，入院时24 h尿蛋白含量、SUA/Cr值及分娩前1周内S/D值是PE患者发生不良妊娠结局的独立危险因素（P<0.05）；（3）入院时SUA/Cr值、24 h尿蛋白含量及分娩前1周内S/D值预测不良妊娠结局的AUC分别为0.890、0.833、0.703，最佳截断值为7.185、327 mg、2.285，灵敏度分别为78.3%、64.2%、72.5%，特异度分别为87.5%、87.5%、67.0%。（4）入院时SUA/Cr值与PE患者不良妊娠结局发生风险呈正相关（P<0.05）。结论　入院时的SUA/Cr值与PE患者不良妊娠结局的发生风险呈正相关，对不良妊娠结局具有一定的预测价值。

Objective To explore the correlation between serum uric acid⁃to⁃creatinine (SUA/Cr) ratio and adverse pregnancy outcomes in patients with preeclampsia (PE). Methods Clinical data of 146 PE patients were retrospectively analyzed. Based on the presence of adverse perinatal pregnancy outcomes, patients were divided into adverse pregnancy outcome group (n=40) or normal pregnancy group (n=106). Clinical data were compared between the two groups. Logistic regression model was adopted to identify factors influencing adverse pregnancy outcomes in PE patients. Receiver operating characteristic curves were plotted, and the area under the curve (AUC) was used to evaluate the predictive value of independent risk factors for adverse pregnancy outcomes. Spearman correlation was performed to analyze the correlation between the SUA/Cr value and adverse pregnancy outcomes. Results (1) Compared with the normal pregnancy group, the adverse pregnancy outcome group exhibited higher systolic blood pressure, diastolic blood pressure, 24⁃hour urinary total protein, SUA level, and a greater SUA/Cr value at admission, as well as a greater systolic⁃to⁃diastolic ratio (S/D) of the fetal umbilical artery within one week before delivery, along with a lower serum albumin level at admission (P<0.05). (2) Multivariate Logistic regression analysis results indicated that 24⁃hour urinary total protein at admission, SUA/Cr value at admission, and S/D value within one week before delivery were independent risk factors for adverse pregnancy outcomes in PE patients (P<0.05). (3) The AUC of SUA/Cr value at admission, 24⁃hour urinary total protein level at admission, and S/D value within one week before delivery for predicting adverse pregnancy outcomes in PE patients were 0.890, 0.833, and 0.703, respectively. The optimal cutoff values were 7.185, 327 mg, and 2.285, with sensitivities of 78.3%, 64.2%, and 72.5%, and specificities of 87.5%, 87.5%, and 67.0%, respectively. (4) The SUA/Cr value at admission positively correlated with the occurrence risk of adverse pregnancy outcomes in PE patients (P<0.05). Conclusion The SUA/Cr value at admission positively correlates with the occurrence risk of adverse pregnancy outcomes in PE patients and exerts predictive value for such outcomes to a certain extent.