早产对产妇远期心脑血管事件的影响  

Impact of premature birth on long term cardio-cerebral vascular events of puerpera

作　　者：李冬青[1] 陶杰[2] 董岩[3] 赵海燕[1] 高新颖[2] 季春鹏[2] 王立姣 向鸿鹄[2] 吴寿岭[1] 

机构地区：[1]河北联合大学附属开滦总院心内科,唐山063000 [2]河北联合大学研究生学院 [3]河北联合大学附属开滦总院林西医院心内科

出　　处：《中华心血管病杂志》2014年第7期598-602,共5页Chinese Journal of Cardiology

摘　　要：目的：探讨早产对产妇远期心脑血管事件的影响。方法采用双向性队列研究，选择1976年10月至2008年12月在开滦医疗集团住院分娩且参加2006年7月至2007年10月健康体检的3659例妇女组成观察队列。根据是否有早产史，将入选者分为早产组（226例）和非早产组（3433例）。随访期间观察研究对象心脑血管事件（包括心肌梗死、脑梗死和脑出血）的发生情况。采用多因素Cox比例风险回归模型分析影响心脑血管事件发生的因素。结果（1）与非早产组比较，早产组分娩年龄、产前收缩压和舒张压、妊娠高血压综合征比例均较大，而新生儿体质量和身长均较小（ P＜0.05或0.01）。健康体检时，早产组年龄、收缩压和舒张压水平均高于非早产组（ P＜0.05或0.01）。（2）随访（15.2±7.8）年，研究对象共发生心脑血管事件71例。早产组心脑血管事件和心肌梗死的发病率分别为3.23/1000人年和2.05/1000人年，均高于非早产组的1.15/1000人年和0.42/1000人年（ P均＜0.05）。校正危险因素后，多因素Cox比例风险回归模型分析显示早产组发生心脑血管事件、心肌梗死事件的危险分别是非早产组的2.03（95％CI：1.02～4.04，P＝0.002）和3.11（95％CI：1.18～8.18，P＜0.001）倍。结论早产妇女远期心脑血管事件和心肌梗死事件的累计发病率高于非早产者。早产是妇女远期心肌梗死事件的独立危险因素。Objective To investigate the impact of premature birth on long term cardio-cerebral vascular events of puerpera.Methods Ambispective cohort study method was used and 3 659 pregnant women giving birth during October 1976 to December 2008 at Kailuan medical group were included and divided into premature birth（PTB） group （n=226） and non-PTB（NPTB） group （n=3 433） by the history of PTB.Incidence of cardio-cerebral vascular events （ myocardial infarction , cerebral infarction and cerebral hemorrhage ） was obtained during follow-up.Multivariable Cox proportional hazards regression models was used to assess the relative risk of cardio-cerebral vascular events.Results （ 1 ） The childbearing age , proportion of pregnancy-induced hypertension , systolic blood pressure and diastolic blood pressure before delivery were significantly higher while weight and height of newborn were significantly less in PTB group than in NPTB group （ P〈0.05 or 0.01 ）.（ 2 ） There were 71 cardio-cerebral vascular events during the follow-up of （15.19 ±7.75） years.In PTB group, the incidence of cardio-cerebral vascular events and myocardial infarction was 3.23/1 000 person-years and 2.05/1 000 person-years, respectively, while the corresponding incidence was 1.15/1 000 person-years and 0.42/1 000 person-years, respectively in NPTB group（ all P 〈0.05 ）.After adjustment for other traditional cardiovascular risk factors , the risk of total cardio-cerebral vascular events, myocardial infarction in PTB group was 2.03 fold（95%CI：1.02-4.04, P=0.002） and 3.11 fold （ 95%CI： 1.18 -8.18, P 〈0.001 ） higher than in NPTB group.Conclusion PTB is an independent risk factor for total cardio-cerebral vascular events , especially myocardial infarction of puerpera.

关 键 词：早产 血管疾病 危险因素 

分 类 号：R714.21[医药卫生—妇产科学]