Study On Risk Factors Prediction Model For Chronic Hypertension Complicated With Preeclampsia Renal Damage

Research background:Hypertensive disorders of pregnancy(HDP)are a group of disorders specific to pregnancy,consisting of Gestational hypertension(GH),Pregnancy with chronic hypertension,Preeclampsia(PE),Chronic hypertension with superimposed preeclampsia,and Eclampsia.These diseases endanger maternal and infant health.Pregnancy with chronic hypertension is highly likely to be complicated by PE,progressing to chronic hypertension complicated by preeclampsia.It leads to multi-organ damage,including the kidneys,and in severe cases,acute renal failure can occur,having adverse effects on the life and health of the mother and child.Objective:To investigate the risk factors for the development of preeclamptic renal damage in women in pregnancy with chronic hypertension,and to develop a prediction model for individualized pregnancy management,with the aim of reducing the risk of preeclamptic renal damage in pregnant women with hypertension.Research method:Through the medical data system of Jinan Maternal and Child Health Hospital,415 singleton pregnant women with chronic hypertension from January 1,2015 to December 31,2021 were selected as the research subjects.Among them,150 patients with pregnancy complicated with chronic hypertension without preeclampsia kidney damage,and 265 patients with chronic hypertension complicated with preeclampsia and kidney damage were selected.Collect general information,disease history,laboratory tests,and other information of all patients.Use SPSS26.0 software(IBM Corp,Armonk,New York)to analyze the data of two groups,including normality tests,independent sample t-tests,non parametric tests,etc.Perform single factor analysis and multiple factor analysis on the various indicators with statistical significance after the above tests,and include the indicators with statistical significance in binary logistic regression.When P<0.05,it is considered statistically significant,and a prediction model is established.At the same time,a Nomogram is drawn for visualization.And the model is evaluated by means of calibration curves.And evaluate the model through receiver operating characteristic(ROC)curves.Research result:The analysis of the clinical data of the two groups showed that elevated Systolic blood pressure(SBP),Lactate dehydrogenase(LDH),Diastolic blood pressure(DBP),Alanine aminotransferase(ALT)and fasting plasma glucose(FPG)were all independent risk factors for renal damage in preeclampsia complicated by chronic hypertension.The results showed that LDH was the largest predictor of renal damage in preeclampsia complicated by chronic hypertension with a score of 100,followed by SBP with a score of 63,ALT with a score of 53,FPG with a score of 36,and DBP with a score of 28.The area under the ROC curve for the prediction model,which is the AUC,was 0.812,with a sensitivity of 70.7%and a specificity of 81.3%for its predictive ability.Research conclusion:In this study,a reasonable and feasible risk factor prediction model for renal damage in preeclampsia complicated by chronic hypertension was established by logistic regression analysis,which included 5 risk factors,SBP,DBP,FPG,LDH and ALT,with high prediction accuracy and sensitivity,and is important for guiding pregnant women with chronic hypertension to reduce the probability of combined PE renal damage.