37周前妊娠高血压合并不同程度蛋白尿对围产儿结局的影响  

To study of perinatal outcomes in pregnancy inducing hypertension (PIH) that is complicated by proteinuria below 37 week.

作　　者：迟心左[1] 刘维靖[1] 

机构地区：[1]首都医科大学宣武医院妇产科,100053

出　　处：《中国优生与遗传杂志》2005年第2期68-69,104,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的　探讨 37w前妊娠高血压合并蛋白尿对围产儿结局的影响。方法　回顾性分析 1998年 1月～ 2 0 0 3年 4月在我院分娩的中重度妊娠高血压综合征病例 ,选取 37w前分娩的妊娠高血压合并蛋白尿孕妇且资料完整的 6 7例作为研究对象 ;按 2 4h尿蛋白定量将病人分中度蛋白尿组 (<5g/ 2 4h)、重度蛋白尿组 (≤ 5 g/ 2 4h) 2组。结果　 6 9例妊娠高血压合并蛋白尿患者中有 4 3例蛋白尿定量 <5 g/ 2 4h(平均 1.77g) ,2 6例蛋白尿定量≥ 5 g/ 2 4h(平均 8.6 5 g) ,中度蛋白尿组分娩孕周比重度蛋白尿组高 ,新生儿出生体重 ,中度蛋白尿组较重度蛋白尿组重 ,差异有显著性 ,围产儿死亡率随蛋白尿的增加而有上升趋势 ,差异有显著性。结论　 37w前妊娠高血压合并蛋白尿孕妇 ,胎儿宫内发育受限的发生率及新生儿病率与蛋白尿排出量成正相关。大量蛋白尿的出现是重度妊高征早发和进展的一个信号 ,适时终止妊娠可改善早产儿预后。Objective: To study of perinatal outcomes in pregnancy induced hypertension(PIH) that is complicated by proteinuria below 37week. Methods: To analytically review the 69 cases of moderate and severe pregnancy induced hypertension below 37 week in our hospital from January 1998 to April 2003. According to protenuria of per 24 hours, patients were characterized as having mild proteinuria group (<5g/24h), severe proteinuria group(≥5g/24h). Results: sixty-nine patients met the inclusion criteria: 43/69 patients had mild priteinuria(mean 1.77g),26/69 patients had severe proteinuria (mean 8.65g). No maternal deaths occurred in two groups. The rate of the most serious preeclampsia complications were increased between the groups (P<0.05). Parturients with mild proteinuria were delivered later than parturients with severe proteinuria, and significant differences (P<0.05). Infants of the severe proteinuria group significantly lower birth weight (P<0.05). The mortality of perinatal deaths increased as the elevation of proteinuria, the severe group was markedly. Conclusion: Women with PIH and severe proteinuria did have increased maternal morbidity compared with women with mild proteinuria. The rate of fetal growth restriction and neonatal mobility were positive relation with the amount of proteinuria. Severe proteinuria appears to be a marker for early onset disease and progression to PIH.

关 键 词：妊娠并发症 心血管 高血压 蛋白尿 早产 

分 类 号：R714.24[医药卫生—妇产科学]