妊娠期高血压患者产后血压变化及其影响因素  

Postpartum change of blood pressure and its risk factors in patients with hypertensive disorders in pregnancy

作　　者：沈琳[1] 谭红专[1] 周书进 柳祎[1] 何玥[1] 胡丽[1] 罗美玲[1] 王莎亚[1] 郭亚伟[1] 蔡畅[1] 

机构地区：[1]中南大学公共卫生学院流行病与卫生统计学系,长沙410078 [2]湖南省浏阳市妇幼保健院,长沙410300

出　　处：《中南大学学报（医学版）》2014年第3期239-244,共6页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(30872167)~~

摘　　要：目的:了解妊娠期高血压患者的产后血压变化情况及其影响因素。方法:采用回顾性队列研究的方法,在浏阳市37个乡镇中整群随机抽取14个乡镇,以所抽乡镇妇幼保健部门2010年1月至2011年12月间登记建册的所有符合要求的孕产妇为目标人群,通过病历资料和孕产妇保健手册资料追溯队列人群从产前到产后42 d的血压情况及相关变量。用χ2检验比较不同高血压类型的产前血压组其产后血压恢复率的差异,采用单因素分析和多因素logistic回归分析影响妊娠期高血压患者产后血压恢复的因素。结果:共460例的妊娠期高血压患者纳入分析,产后42 d血压恢复率达88.7%。多因素分析结果显示:高龄(OR=0.436)、妊娠期高血压疾病严重程度(OR=0.436)、收缩压(SBP)和舒张压(DBP)均高的高血压类型(OR=0.192)是产后高血压持续的危险因素。结论:大部分妊娠期高血压患者在产后42 d内可恢复正常血压,对高龄、妊娠期高血压疾病的病情严重及SBP和DBP均高的高血压患者,需要密切关注。Objective: To investigate the change of blood pressure in patients with hypertensive disorders in pregnancy at er delivery and the risk factors. Methods: In a retrospective cohort study, we collected subjects from villages and towns in Liuyang by cluster sampling method. Before enrolling in this cohort, all had established health records from January 2010 to December 2011. We collected the medical records and maternal health care manuals of this cohort as our data materials, focusing on the blood pressure records as well as related features. We compared the dif erences of recovery rate of postpartum blood pressure in dif erent kinds of antenatal blood pressure groups with χ2 test. In order to explore the main factorsinl uencing the recovery rate of blood pressure of patients with hypertensive disorders in pregnancy, we conducted univariate and multivariate analysis by χ2 test and unconditional logistic regression analysis. Results: Among the 460 women with hypertensive disorders in pregnancy in our analysis, the recovery rate of postpartum blood pressure reached 88.7%. Multivariate analysis showed that the risk factors influencing the recovery rate of postpartum blood pressure included advanced age(OR=0.436), higher degree of hypertensive disorders in pregnancy(OR=0.436), and hypertension with simultaneously high systolic and diastolic blood pressures(OR=0.192). Conclusion: For most patients with hypertensive disorders in pregnancy, the blood pressure may decrease to normal level 42 days after delivery. Women with advanced age, higher degree of hypertensive disorders in pregnancy and hypertension with simultaneously high systolic and diastolic blood pressures should be given more at ention.

关 键 词：妊娠期高血压疾病 产后 血压 

分 类 号：R544.1[医药卫生—心血管疾病]