作者：Livingston JR，et al

翻译：山东省烟台市烟台山医院 宗世华

摘要：目的：血清尿酸升高常见于子痫前期妇女，但其在预测不良妊娠结局方面的应用最近一直存在争议。我们的目标是分析大量子痫前期妇女的数据，以确定血清尿酸在预测不良的孕产妇和围产期结局中的作用。

【摘要】

方法：数据来源于一项正在进行的国际前瞻性研究，研究的对象是子痫前期住院的妇女（子痫前期综合风险评估）。单因素Logistic回归分析，以确定血清尿酸浓度（绝对和胎龄校正[Z评分]）和不良结局（孕产妇和围产期）之间的关系。分析比较了高血压和蛋白尿与高血压和高尿酸血症定义的先兆子痫妇女队列。

结果：尿酸Z评分与不良围产期结局相关(OR 1.5;95% CI 1.4-1.7)，且点估计值> 0.7(受试者工作特性的曲线下面积为0.72;95% CI 0.69- 0.74)。血尿酸浓度与不良孕产妇结局也有显著的相关性，但点估计值< 0.7。以高血压和蛋白尿为先兆子痫的组与以高血压和高尿酸血症为先兆子痫的组之间无显著差异。

结论：在入院治疗子痫前期的妇女中，血清尿酸浓度(通过Z评分校正孕周)在预测不良围产期结局方面具有临床应用价值，但不能预测产妇结局。

附原文：

Abstract OBJECTIVE: Elevated serum uric acid is commonly observed in women with preeclampsia, but its utility in predicting adverse outcomes has recently been disputed.Our goal was to analyze data from a large cohort of women with preeclampsia to determine the utility of serum uric acid in predicting adverse maternal and perinatal outcomes. METHODS: Data were obtained from an ongoing international prospective study of women admitted to hospital with preeclampsia (Pre-eclampsia Integrated Estimate of RiSk). Univariate logistic regression was used to determine the relationship between serum uric acid concentration (both absolute and gestational-age corrected [Z score]) and adverse outcomes (maternal and perinatal). Analyses were conducted to compare cohorts of women with preeclampsia as defined by hypertension and proteinuria versus hypertension and hyperuricemia. RESULTS: Uric acid Z score was associated with adverse perinatal outcome (OR 1.5; 95% CI 1.4 to 1.7) and had a point estimate > 0.7 (area under the curve receiver operating characteristic 0.72; 95% CI 0.69 to 0.74). Serum uric acid concentration also showed a significant association with adverse maternal outcomes, but the point estimate was < 0.7. No significant differences were observed between groups in which preeclampsia was defined by hypertension and proteinuria and by hypertension and hyperuricemia. CONCLUSION: In women admitted to hospital with preeclampsia, the serum uric acid concentration, corrected for gestational age via a Z score, is clinically useful in predicting adverse perinatal outcomes but not maternal outcomes.

引自：

Livingston JR, Payne B, Brown M, Roberts JM, Côté AM, Magee LA, von Dadelszen P; PIERS Study Group. Uric Acid as a predictor of adverse maternal and perinatal outcomes in women hospitalized with preeclampsia. PMID: 25375299doi: 10.1016/S1701-2163(15)30435-7.