影响子痫前期孕妇产后发生高血压的危险因素研究  

Risk factors affecting the occurrence of hypertension in preeclampsia women

作　　者：张旋[1] 刘毅[2] 柯丽娜[1] 夏美艳[1] 

机构地区：[1]湖北医药学院附属东风医院妇产科,湖北十堰442008 [2]湖北医药学院附属东风医院泌尿外科,湖北十堰442008

出　　处：《中国性科学》2016年第10期118-123,共6页Chinese Journal of Human Sexuality

基　　金：湖北省教育厅科学技术研究项目(B20102106)

摘　　要：目的:探讨影响子痫前期(PE)孕妇产后发生高血压的危险因素。方法:选取于2009年3月至2013年12月收治于我院的子痫前期孕妇780例(PE组)以及孕周、年龄相当的正常孕妇2980例(正常妊娠组)进行前瞻性分析及对比。研究对象入组时登记基本资料,并检测糖脂代谢指标。于2013年6月至2014年6月对研究对象进行召回,并对其中596例PE组患者和2380例正常妊娠组孕妇进行随访,评估产后高血压发生情况,并检测产后糖脂代谢指标。对产后高血压的影响因素进行二元Logistic回归分析。结果:PE组患者产后高血压率(18.12%)均明显高于正常妊娠组(1.05%),差异具有统计学(P<0.001);重度PE患者产后高血压发生率(21.51%)与轻度PE患者(15.41%)无明显差异(P=0.055);产前体质指数、收缩压、空腹血糖、甘油三酯,产后体质指数、空腹血糖,以及产前产后收缩压、甘油三酯、HOMA-IR、HDL-C差值均是PE患者产后高血压的危险因素(P=0.005,P=0.003,P=0.022,P=0.024,P=0.007,P=0.007,P=0.009,P=0.037,P=0.029,P=0.009)。结论:PE患者产后高血压发生率提高,孕期血压和糖脂代谢异常是其重要影响因素。Objectives： To explore the risk factors affecting the occurrence of hypertension in preeclampsia women. Methods： 780 preeclampsia pregnant women（ PE group） and 2980 normal pregnant women（ normal pregnant women group） with the same gestational weeks and age in our hospital from March 2009 to December 2013 were selected to make a prospective analysis and comparison. The basic data of the study were enrolled in the study,and the metabolic parameters of glucose and lipid were detected. All patients were recalled from June 2013 to June2014,and the 596 patients with PE and 2380 normal pregnant women were followed up to evaluate the occurrence of postpartum hypertension,and detect the metabolic indexes of postpartum glucose and lipid. The influencing factors of postpartum hypertension were analyzed by binary Logistic regression analysis. Results： The rate of postpartum hypertension（ 18. 12%） in the PE group was significantly higher than that in the normal pregnancy group（ 1. 05%）,with statistically significant difference（ P〈 0. 001）. The incidence of postpartum hypertension（ 21. 51%） in severe PE group was not significantly different from that in mild PE group（ 15. 41%）,without statistically significance（ P = 0. 055）. Prenatal BMI,systolic blood pressure,fasting blood glucose,triglyceride,postpartum body mass index,fasting blood glucose,and the difference of the post and postpartum systolic blood pressure,triglyceride,HOMA- IR,HDL- C were all the risk factors of PE patients with postpartum hypertension（ P = 0. 005,P =0. 003,P = 0. 022,P = 0. 024,P = 0. 007,P = 0. 007,P = 0. 009,P = 0. 037,P = 0. 029,P = 0. 009）. Conclusion：The incidence of hypertension in PE patients increases,with abnormal blood pressure and glucose and lipid metabolism as important influencing factors.

关 键 词：子痫前期 高血压 孕期血压 糖脂代谢指标 危险因素 

分 类 号：R714.25[医药卫生—妇产科学]