早发型重度子痫前期不良结局及其关联因素的回顾性研究  

Adverse outcomes of patients with early-onset severe preeclampsia and the relevant factors: a retrospective study

作　　者：曲博[1] 何津[1] 徐鹏[1] 莫言香[1] 陈忱[1] 谷继爽 舒畅[1] 

机构地区：[1]吉林大学第一医院妇产科,吉林长春130021

出　　处：《中国妇幼保健》2018年第3期492-495,共4页Maternal and Child Health Care of China

基　　金：国家自然科学基金(81501279);吉林省科技发展计划项目(20160101058JC)

摘　　要：目的探讨早发型重度子痫前期不良结局及其影响因素的关联性。方法回顾性分析2015-2016年吉林大学第一医院收治的早发型重度子痫前期患者699例,分为无不良结局组576例和不良结局组123例;其中母体不良结局47例,胎儿不良结局56例,母体及胎儿同时发生不良结局20例。应用t检验和Logistic回归分析各因素与早发型重度子痫前期不良结局的关联性。结果在所有不良结局中,胎儿宫内窘迫占34.15%。不良结局组中妊娠28周前发生不良结局33例占26.83%,妊娠28~34周90例占73.17%。乳酸脱氢酶和ALT升高是发生不良结局的危险因素,乳酸脱氢酶升高是胎盘早剥发生的危险因素,白蛋白降低和乳酸脱氢酶升高是胎儿窘迫发生的危险因素。结论在早发型重度子痫前期期待治疗的同时重视危险因素的变化、根据化验结果评估患者病情严重程度并适时终止妊娠有助于改善母婴结局。Objective To explore the correlations between adverse outcomes and the influencing factors in patients with early-onset severe preeclampsia. Methods A total of 699 patients with early-onset severe preeclampsia treated in the First Hospital of Jilin University from 2015 to 2016 were analyzed retrospectively,then they were divided into non-adverse outcome group（ 576 patients） and adverse outcome group（ 123 patients）. In adverse outcome group,47 cases with maternal adverse outcomes,56 cases with fetal adverse outcomes,and 20 cases with maternal and fetal adverse outcomes were included. The correlations between adverse outcomes and the influencing factors were analyzed by t test and logistic regression analysis. Results Among the adverse outcomes,fetal intrauterine distress accounted for34. 15%. In adverse outcome group,adverse outcomes occurred before the 28 th gestational weeks in 33 patients（ 26. 83%） and during the28 th-34 th gestational weeks in 90 patients（ 73. 17%）. Elevated lactate dehydrogenase and alanine aminotransferase（ ALT） levels were the risk factors of adverse outcomes. Elevated lactate dehydrogenase level was the risk factor of placental abruption. Reduced albumin level and elevated lactate dehydrogenase level were risk factors of fetal distress. Conclusion At the same time of expectant management,attaching importance to the change of risk factors,evaluating the severity of patients according to the test results,and terminating pregnancy timely contribute to improvement of maternal and infantile outcomes in patients with early-onset severe preeclampsia.

关 键 词：妊娠期高血压疾病 早发型重度子痫前期 不良结局 

分 类 号：R714.245[医药卫生—妇产科学]