子痫前期孕妇尿蛋白水平与妊娠结局的关系  

Relationship of urine protein level and adverse pregnancy outcomes in pregnant women with preeclampsia

作　　者：柴利强[1] 陈大立[1] 彭兰[1] 许慧[1] 周蓦[1] 汤在祥[2] 高红 金蕾[4] 周玉珍 汪云[1] 

机构地区：[1]苏州市立医院(苏州母子保健中心),江苏省215000 [2]苏州大学公共卫生学院 [3]苏州市吴江第一人民医院 [4]苏州市吴中人民医院 [5]苏州市中西医结合医院

出　　处：《江苏医药》2017年第5期337-340,共4页Jiangsu Medical Journal

基　　金：2013年苏州市临床重点病种诊疗技术专项(LCZX201308);苏州市临床医学中心科研项目(Szzx201505);江苏省妇幼健康科研项目(F201540)

摘　　要：目的探讨子痫前期孕妇尿蛋白水平与妊娠结局的关系。方法回顾性分析子痫前期孕妇1239例的临床资料,分析尿蛋白水平与不良妊娠结局的关系。结果以尿蛋白定性分为"+1"(405例)、"+2"(474例)和"≥+3"(360例)三组,其孕妇不良妊娠结局发生率分别为3.21%、5.70%和13.89%,胎儿不良结局发生率分别为5.19%、10.13%和15.56%,新生儿不良结局发生率分别为11.93%、25.00%和44.85%。Logistic回归分析显示,随着尿蛋白水平增加,孕妇、胎儿和新生儿不良结局发生风险显著增加。母亲不良结局以HELLP综合征、胎盘早剥和眼底渗出、水肿、出血为主;胎儿不良结局以胎儿生长受限为主;新生儿不良结局以低出生体重、新生儿死亡为主。各不良结局发生风险与尿蛋白相关(P<0.05或P<0.01)。结论孕妇子痫前期伴有大量尿蛋白是不良妊娠结局的重要因素之一。Objective To investigate the association of urine protein level and pregnancy outcomes in pregnant woman with preeclampsia. Methods The data of 1239 pregnant women with preeclampsia were retrospectively reviewed and the association between urine protein level and adverse pregnancy outcomes was analyzed. Results On the basis of qualitative analysis of urinary protein, the pregnant women were assigned into three groups of ＂3-1＂（405 cases） ,＂3-2＂（474 cases） and ＂≥3-3＂ （360 cases）, for which the maternal adverse outcomes were 3.21%, 5.70% and 13.89%, the fetal adverse outcomes were 5. 19%, 10. 13% and 15.56%, and the newborn adverse outcomes were 11.93 %,0.25 % and 44. 85%, respectively. Logistic regression analysis showed that the risk for adverse pregnancy outcomes was increased significantly as the increase of urine protein. Maternal adverse outcomes mainly included HELLP syndrome, placental abruption and retinal hemorrhage. Fetal adverse outcomes mainly included fetal growth restriction. Newborn adverse outcomes mainly included low bodyweight and newnatal mortality. All these adverse pregnancy outcomes were closely associated with the increase of urine protein level（P〈0. 05 or P〈0. 01）. Conclusion Abnormal increase of urine protein is one of the important risk factors for adverse pregnancy outcomes in pregnant woman with hypertension and preeclampsia.

关 键 词：尿蛋白 子痫前期 妊娠结局 

分 类 号：R714[医药卫生—妇产科学]