29例肾病综合征型子痫前期的临床研究  

Clinical study of 29 cases of nephrotic syndrome with preeclampsia

作　　者：瞿琳[1] 殷茵[1] 周欣[1] Qu Lin;Yin Yin;Zhou Xin(Department of Obstetrics,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029)

机构地区：[1]南京医科大学第一附属医院产科

出　　处：《现代妇产科进展》2019年第10期761-764,768,共5页Progress in Obstetrics and Gynecology

基　　金：江苏省妇幼健康科研项目(江苏省卫生和计划生育委员会,No:F201658);江苏省妇幼卫生健康重点人才(省卫生计生委,No:FRC)

摘　　要：目的:探讨肾病综合征型子痫前期(NSP)患者的临床特点、母胎并发症、妊娠结局,以及相关影响因素。方法:回顾分析2018年1月至7月南京医科大学第一附属医院产科收治的29例NSP产妇(NSP组)和62例重度子痫前期未合并肾病综合征患者(对照组)的临床资料。比较两组患者的一般情况、临床表现、实验室检查结果及围生期结局。结果:与对照组比较,NSP组患者发病早,临床症状重,肾功能损伤严重,血浆白蛋白水平降低,总胆固醇、甘油三酯、尿素氮、肌酐值升高,胸腹腔积液、早产、脐血流异常、胎儿生长受限、新生儿转儿科率增高(P<0.05)。Logistic回归分析提示,妊娠周数、妊娠期血浆白蛋白是NSP发生的保护因素,血浆总胆固醇和严重水肿症状是影响NSP发生的独立危险因素。结论:NSP具有发病早、病情重等特点,临床上要加强产前检查,提高对该病的识别能力,可根据母胎病情具体变化,适时终止妊娠,以减少严重并发症发生,降低围生儿死亡率。Objective:To analyze the clinical characteristics,maternal-fetal complications,pregnancy outcomes and related factors of nephrotic syndrome with preeclampsia.Methods:Retrospectively analyzed the clinical datas of 29 cases of nephrotic syndrome with preeclampsia who were treated in the obstetrics department of The First Affiliated Hospital of Nanjing Medical University.62 patients with severe preeclampsia without nephrotic syndrome were served as control group.The general conditions,clinical manifestations,laboratory results and perinatal outcomes of the two groups were compared.Results:Compared with the control group,the nephrotic syndrome group had earlier onset,more severe clinical symptoms and renal injury,lower plasma albumin level,higher total cholesterol,triglyceride,urea nitrogen,creatinine,pleural and celiac effusion,premature delivery,abnormal umbilical cord blood flow,fetal growth restriction,and neonatal conversion rate to pediatrics were increased(P<0.05).Logistic regression analysis showed that gestational weeks,plasma albumin during pregnancy were the protective factors for the occurrence of NSP,plasma total cholesterol and severe edema were independent risk factors for the occurrence of NSP.Conclusions:Nephrotic syndrome with preeclampsia has the characteristics of early onset and heavy illness.Prenatal examination should be strengthened and the ability to identify the disease should be improved.According to the specific changes of maternal and fetal conditions,pregnancy can be terminated in due time,so as to reduce the occurrence of severe complications and the perinatal mortality.

关 键 词：肾病综合征 子痫前期 

分 类 号：R714.4[医药卫生—妇产科学]