43例起病与妊娠相关的肾脏病患者的临床分析  

43 Cases Analysis on Women whose Kidney Disease Onset Related to Pregnancy

作　　者：刘玉梅[1] 鲍宏达[1] 黄亚娟[2] 汪年松[1] 

机构地区：[1]上海交通大学附属第六人民医院肾脏风湿科,上海200233 [2]上海交通大学附属第六人民医院妇产科,上海200233

出　　处：《中国中西医结合肾病杂志》2014年第12期1072-1076,共5页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家自然基金面上项目(No.81270824);上海市科委引导类项目(No.114119a6100);上海市科委基金资助项目(No.11DZl921904)

摘　　要：目的：了解起病与妊娠相关的肾脏病女性患者的发病率、病因及一般情况。方法：收集2004年8月~2013年1月肾脏科,于妊娠期间及产后6个月内诊断为肾脏病的女性患者,并记录其临床资料。结果：起病与妊娠相关的肾脏病女性的发病率为1.49%（43/2 891）,53.4%为CKD1~2期患者,6名女性进入终末期肾脏病（0.208%）。67.4%在妊娠期间诊断为肾脏病,大部分因蛋白尿发现（46.5%）。最多的临床诊断为慢性肾小球肾炎（27.9%）,最多的病理诊断为Ig A肾病（50%）。平均血红蛋白浓度为（105±30）g/L,血钙磷代谢异常比例为20.9%。妊娠至诊断肾脏病的平均时间为（128±288）周（中位数25周）,她们的剖宫产比例及死产比例均高于健康妊娠女性（53.8%比16.7%,60%比0%,P〈0.05）。43名中的8名女性接受肾脏替代治疗。结论：起病与妊娠相关的肾脏病女性患者的发病率高于文献报道,这些女性的临床及病理诊断与我国慢性肾脏病的流行病学一致,他们贫血及钙磷代谢的控制情况不理想。Objective：To learn the incidence,causes and general condition of women whose kidney disease onset related to pregnancy. Methods：Women of Han ethnics whose kidney disease onset related to pregnancy were collected from August 2004 to Jan-uary 2013 in nephrology department Inclusive criteria was women diagnosed with kidney disease during pregnancy or within six -month after delivery. Clinical data were recorded. Results：The incidence of women whose kidney disease onset related to pregnancy is 1. 49%（43/2 891）. 53. 4% women in chronic kidney disease stage 1 ~2. Six women proceeded to end stage renal disease （0. 208%）. Most were discovered during pregnancy（67. 4%）,for discovering proteinuria（46. 5%）. The most clinical diagnosis was chronic glomerularnephritis（27. 9%）. The most pathological diagnosis was IgA nephropathy（50%）. Mean hemoglobin was （105 ＆#177; 30）g/L. Percentage of calcium and phosphorus abnormalities was 20. 9%. Average week from gravidity till kidney disease di-agnosis was（128 ＆#177; 288）weeks,median for 25 weeks. Their proportion of cesarean section and stillbirth were higher than normal pregnant women（53. 8% VS 16. 7% and 60% VS 0%,P〈0. 05）. Eight out of 43 women received renal replacement therapy. Conclusion：The incidence of women whose kidney disease onset related to pregnancy is higher than reported. The clinical and patho-logical diagnosis of these women are consistent with epidemiology of kidney disease in China. Management of their anemia and calcium or phosphorus were not optimistic.

关 键 词：贫血 慢性肾脏病 妊娠结局 肾穿刺 肾脏替代治疗 

分 类 号：R714.258[医药卫生—妇产科学]