子癎前期患者蛋白尿程度与围生儿结局的研究  

Study on the Relationship Between Severity of Proteinuria and Perinatal Outcomes in Women with Preeclampsia

作　　者：李桦[1] 马玉燕[1] 王磊一[1] 傅庆诏[1] 

机构地区：[1]山东大学齐鲁医院

出　　处：《实用妇产科杂志》2007年第6期357-359,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨子癎前期患者蛋白尿程度对其围生儿结局的影响。方法:对287例住院分娩的子癎前期患者根据蛋白尿程度进行分组,分别回顾性研究其围生儿结局,比较不同程度蛋白尿患者围生儿结局的差异。结果:随患者蛋白尿的加重,分娩孕周提前,新生儿出生体重明显下降;剖宫产分娩和治疗性引产数升高,而自然分娩数减少;低体重儿发生率、围生儿死亡率、医源性早产率、收住NICU率均明显升高,但新生儿窒息发生率差异无显著性。将所有病例根据分娩孕周分为两组,≥32周分娩者其围生儿结局在不同程度蛋白尿患者各组之间差异显著,而32周之前分娩者其围生儿结局在不同程度蛋白尿之间差异无显著性。结论:随蛋白尿加重,围生儿结局恶化,但较早的早产儿中,孕龄过小是造成围生儿不良结局的另一不利因素,因而终止妊娠应适时。Objective： To study on the effect of severity of proteinuria on the perinatal outcome in pregnant with preeclampsia. Methods. Records of 287 pregnancies with preeclampsia who delivered between Jan 2002 and Dec 2004 were reviewed. Patients with underlying renal disease, essential hypertension, cardiac disease, diabetes mellitus, thyroid disease were excluded. Patients were characterized according to severity of proteinuria as mild （0.3 - 1.9g/24h ）, moderate （ 2 - 4.9g/24h ）, severe （5 - 9.9g/24h ） or massive （ t〉 10g/24h ）. The perinatal outcome were analyzed and compared. Results. With aggravation of proteinuria, earlier gestational weeks at delivery, the birth weight of neonatus decreased. The number of caesarean and therapeutic induced delivery increased as spontaneous delivery reduced. Meantime, the rate of low birth weight infant, perinatal mortality, iatrogenic preterm birth, and admission to NICU increased, But the incidenceof neonatal asphysia was no significant difference among them, In the patients delivered below 32 gestational weeks, there was no significant difference of perinatal outcome among groups. But there was remarkably difference in perinatal outcome among groups that delivery beyond 32 gestaUonal weeks. Conclusions; Proteinuria appeared to be a marker for progression to severe preeclampsia, massive proteinuria seemed to be closely correlated to worse perinatal outcome, 10ut in very early preterm patients, the perinatal outcome was closely associated with gestational age. So the decision for termination of pregnancy should be in appropriate time.

关 键 词：子癇前期 蛋白尿 围生儿结局 

分 类 号：R714.24[医药卫生—妇产科学]