重度子痫前期孕妇血浆蛋白变化与围产儿结局关系的研究

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目的:通过比较重度子痫前期孕妇血浆蛋白的变化对围生儿结局的影响,探讨临床对重度子痫前期孕妇诊治及改善围生儿结局的方法。方法:选取50例重度子痫前期孕妇及其新生儿为病例组,50例正常妊娠孕妇及新生儿为对照组,两组均已排除慢性肝肾疾病患者。分别测空腹血浆蛋白含量,并将病例组分为低蛋白血症组和非低蛋白血症组,回顾性分析病例组和对照组两组间及病例组内血浆蛋白的差异及对围生儿结局(终止妊娠的孕周及新生儿体重)的影响。结果:病例组血浆总蛋白(TP)、白蛋白(Alb)含量、终止妊娠的孕周及新生儿体重均明显低于对照组(P<0.05),而两组间球蛋白(GT)无明显差异。病例组内低蛋白血症组(A组)与非低蛋白血症组(B组)间终止妊娠孕周差异无统计学意义,但新生儿出生体重、Apgar评分均低于后者,且围生儿死亡率亦较高,差异有统计学意义。结论:终止妊娠的孕周是围生儿预后是否良好的重要参数,重度子痫前期孕妇组血浆蛋白含量越低、围生儿的体重越小、Apgar评分越低预后越差,死亡率越高,提示重度子痫前期孕妇血浆蛋白的变化可作为预测围生儿结局的指标,维持母体血浆白蛋白水平有利于改善围生儿结局。 Objective: To compare the effect of plasma protein in pregnant women with severe preeclampsia on the outcomes of perinatal infants, and to explore the methods of clinical diagnosis and treatment and the improvement of perinatal outcome in pregnant women with severe preeclampsia. Methods: Fifty pregnant women with severe preeclampsia and their newborns were selected as case group, 50 normal pregnant women and newborn as control group, and both groups had been excluded from chronic liver and kidney disease. Fasting plasma protein levels were measured, and the cases were divided into hypoproteinemia group and non-hypoproteinemia group. The differences of plasma proteins in case group and control group and in case group were retrospectively analyzed. Outcome (gestational age at termination of pregnancy and birth weight). Results: The levels of total protein (TP) and albumin (Alb), gestational weeks of gestational termination and newborn weight in case group were significantly lower than those in control group (P <0.05), but there was no significant difference in globulin (GT) between the two groups difference. There was no significant difference in gestational age between the group of hypoproteinemia (group A) and non-hypoproteinemia group (group B), but the neonatal birth weight and Apgar score were lower than the latter Neonatal mortality is also higher, the difference was statistically significant. Conclusion: The gestational age at termination of pregnancy is an important parameter of whether the prognosis of perinatal children is good. The serum protein level of pregnant women with severe preeclampsia is lower, the weight of perinatal children is smaller, the Apgar score is lower, the prognosis is worse, and the mortality rate is higher , Suggesting that the change of plasma protein in pregnant women with severe preeclampsia may be used as an index to predict the outcome of perinatal children. Maintaining the level of maternal plasma albumin is beneficial to the improvement of perinatal outcome.
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