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目的:探讨子痫前期患者腹腔积液时病理状况及相关生化因素。方法:对100例子痫前期患者的临床资料依有无腹腔积液分为伴积液组(研究组)56例和不伴积液组(对照组)44例,所有患者均行血清学生化检查,对两组患者血蛋白、肝肾功、血脂、血糖、电解质及妊娠结局进行统计学分析。结果:研究组患者心脏、肝脏、眼底等重要器官合并症发生率为30.4%,较不伴腹水者明显增加;两组患者在剖宫产率、早产率、平均动脉压、分娩孕周等方面差异无统计学意义(P>0.05),在尿蛋白定量、住院孕周延长、新生儿体重、FGR发生率、胎盘早剥发生率、胎儿丢失率等方面研究组表现出明显的负面趋势;对照组患者有更高的多胎妊娠发生率。进行单因素Logistic回归分析显示,血清LDL-C、CHO、LDH、UA、TP、ALB等生化因素在两组患者间差异有统计学意义(P<0.05),多因素Logistic逐步回归分析ALB、TP、LDH、CHO与腹水发生的B值分别为-0.30、-0.267、0.013、0.582,OR值分别为1.349、0.766、1.013、1.790。结论:伴腹水子痫前期患者有更高的重要器官合并症发生率,子痫、HELLP综合征、胎盘早剥等产科并发症以及FGR、死胎等胎儿结局更差。血清总蛋白和白蛋白是腹水的保护性因素,乳酸脱氢酶和胆固醇是腹水形成的危险因素。
Objective: To explore the pathological conditions and related biochemical factors in patients with preeclampsia ascites. Methods: The clinical data of 100 patients with preeclampsia were divided into 56 cases with effusion group (study group) and 44 cases without effusion group (control group) according to the presence of ascites. All patients underwent serological biochemical tests The blood protein, liver and kidney function, blood lipids, blood glucose, electrolytes and pregnancy outcomes of two groups were statistically analyzed. Results: The complication rate of heart, liver, fundus and other vital organs in study group was 30.4%, which was significantly higher than that in patients without ascites. The incidence of cesarean section, preterm birth rate, mean arterial pressure, gestational age of delivery and so on The difference was not statistically significant (P> 0.05). The study group showed a significant negative trend in urine protein quantitation, prolonged hospitalization for gestational weeks, birth weight, incidence of FGR, incidence of placental abruption and fetal loss rate. Patients in the group had a higher incidence of multiple pregnancies. Univariate logistic regression analysis showed that the biochemical factors such as serum LDL-C, CHO, LDH, UA, TP, ALB were significantly different between the two groups (P <0.05) , B values of LDH, CHO and ascites were -0.30, -0.267, 0.013 and 0.582 respectively, with OR values of 1.349, 0.766, 1.013 and 1.790 respectively. CONCLUSIONS: Patients with ascites and preeclampsia have a higher prevalence of major organ complications, obstetric complications such as eclampsia, HELLP syndrome, placental abruption, and worse fetal outcomes such as FGR and stillbirth. Serum total protein and albumin are protective factors of ascites, lactate dehydrogenase and cholesterol are risk factors for the formation of ascites.