妊娠期糖代谢异常孕妇微量蛋白尿发生率及其临床意义  

Prevalence of albuminuria in pregnant women with hyperglycemia and its association with adverse pregnancy outcomes

作　　者：黄启涛[1] 高云飞[1] 钟梅[1] 王艳[1] 梁伟璋[1] 张敏[1] 行李琳[1] 裘毓雯[1] 

机构地区：[1]南方医科大学南方医院妇产科,广东广州510515

出　　处：《中国实用妇科与产科杂志》2014年第3期197-200,共4页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的研究妊娠期糖代谢异常孕妇尿微量蛋白阳性的发生率，以及尿微量蛋白阳性和阴性时不良妊娠结局的发生是否存在差异。方法选择2010年9月至2012年2月在南方医科大学南方医院定期产检并分娩的糖代谢异常孕妇152例，根据妊娠24～28周尿微量蛋白肌酐比情况分为尿微量蛋白阳性组23例，阴性组129例。比较两组孕妇临床特征和妊娠结局。结果（1）妊娠期糖代谢异常孕妇微量蛋白尿的发生率为15．1％。尿微量蛋白阳性组孕妇年龄、体重指数（BMI）、平均动脉压、糖化血红蛋白、尿微量蛋白肌酐比以及胰岛素用量明显高于尿微量蛋白阴性组孕妇（P〈0．05）。（2）尿微量蛋白阳性组和阴性组孕妇比较，子痫前期（34．8％vs.10．1％）、早产（39．1％vs.14．7％）、胎膜早破（26．1％vs．17．1％）和巨大儿（13．0％vs.27．1％）发生率差异均有统计学意义（P〈0．05）。结论尿微量蛋白阳性组孕妇不良妊娠结局的发生率明显高于尿微量蛋白阴性组孕妇，提示尿微量蛋白可能是高危妊娠孕妇早期预测不良妊娠结局发生有效的指标。Objective To investigate the prevalence of albuminuria in pregnant women with hyperglycemia and to explore whether the incidence of adverse pregnancy outcomes would increase with albuminuria. Methods Between September, 2010 and February, 2012, 152 pregnant women with hyperglycemia were enrolled in this study. Urine tests for albuminuria and creatinine measurements were performed in all women during gestational 24-28 weeks, and the albumin to creatinine ratio （ACR） was calculated. The clinical features and pregnant outcome of 23 pregnant women with albuminuria（ exposed group ） and 129 women without albuminuria（ control group） were analyzed. Results （ 1 ） Prevalence of albuminuria pregnant women with hyperglycemia in this study is 15.1%. Pregnant women with albuminuria are more likely to have higher level in respect to age, BMI, mean arterious blood pressure, HbA1 C, albuminuria to creatinine ratio and the sum of insulin use when compared with the pregnant women without albuminuria（ P 〈 O. 05 ）. （2） Pregnancy outcomes between pregnant women with or without albuminuria： Preeclampsia （34. 8% vs. 10. 1% ）, preterm labor （39. 1% vs. 14. 7% ）, preterm premature rupture of membranes （26. 1% vs. 17.1% ） and macrosomia（ 13.0% vs. 27.1% ）were signi？ eantly different in women with and without albuminuria（ P 〈 0.05 ）. Conclusion Pregnant women with albuminuria had a higher rate of adverse pregnancy outcome. And it may have a predictive value of adverse pregnancy outcomes in women with high risk pregnancy.

关 键 词：妊娠期糖尿病 蛋白尿 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]