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目的探讨妊娠期高血压疾病肾脏损伤与母婴结局的相关性。方法选取2013年1月-2014年3月该院收治的妊娠期高血压患者213例为研究对象,根据尿蛋白水平分为4组,A组:蛋白尿(-)66例;B组:蛋白尿(+)55例;C组:蛋白尿(++)33例;D组:蛋白尿(+++)59例。记录4组孕产妇的年龄、体重、产次等基本资料;检测尿酸、尿素、肌酐(Cr)、白蛋白(Alb)水平;观察并测量胎儿脐血S/D值、新生儿体重、胎盘重量、娩出后1 min和5 min的新生儿Apgar评分、羊水污染情况。结果 D组孕产妇入院时收缩压和舒张压均明显高于其他3组,血浆Alb含量明显低于其他3组,差异有统计学意义(P<0.05);随着孕产妇尿蛋白的增多,肾功能检测尿酸、尿素、Cr水平明显升高,D组孕产妇肾功能检测指标均明显高于其他3组,差异有统计学意义(P<0.05)。D组分娩时妊娠天数明显短于其他3组,S/D值和新生儿死亡率明显高于其他3组,胎盘重量和新生儿体重明显低于其他3组,差异均有统计学意义(均P<0.05)。D组新生儿娩出1 min和5 min时Apgar评分<4分比例均明显高于其他3组,且羊水3度污染比例明显高于其他3组,差异均有统计学意义(P<0.05)。结论妊娠期高血压疾病肾损伤发生率较高,且与孕妇病情和围产儿结局紧密相连;早期发现并采取积极干预治疗对缓解病情发展,改善母婴结局具有重要意义。
Objective To investigate the relationship between renal damage in pregnancy-induced hypertension and maternal-infant outcome. Methods Totally 213 hypertensive patients admitted to our hospital from January 2013 to March 2014 were enrolled in this study. According to urinary protein levels, they were divided into 4 groups: Group A: proteinuria (-) 66; Group B: protein 55 cases of urine (+); Group C: 33 cases of proteinuria (++); Group D: 59 cases of proteinuria (+++). The basic data such as the age, weight and delivery time of the four maternal groups were recorded. The levels of uric acid, urea, creatinine (Cr) and albumin (Alb) were measured. The S / D value, neonatal weight, , 1 and 5 min after neonatal Apgar score, amniotic fluid contamination. Results Compared with the other three groups, the systolic and diastolic blood pressure of pregnant women in group D were significantly higher than those in the other three groups, and the plasma Alb levels were significantly lower than those in the other three groups (P <0.05). With the increase of urinary protein in pregnant women, Renal function tests showed that the level of uric acid, urea and Cr were significantly increased. The indexes of renal function in pregnant women in group D were significantly higher than the other three groups (P <0.05). The gestational days of childbirth in group D were significantly shorter than the other three groups, the S / D value and neonatal mortality rate were significantly higher than the other three groups, and the weight of placenta and neonatal body weight were significantly lower than the other three groups P <0.05). In group D, Apgar scores <4 at 1 min and 5 min after delivery were significantly higher than those in the other 3 groups, and the third degree of amniotic fluid contamination was significantly higher than the other three groups (P <0.05). Conclusions The incidence of renal damage in hypertensive disorder complicating pregnancy is high, and it is closely linked with the condition of pregnant women and the outcome of perinatal infants. Early detection and treatment with active intervention are of great significance in alleviating the progression of the disease and improving the outcome of infants and mothers.