产前子痫及产后子痫临床特征分析  

Comparison and Analysis of Clinical Characteristics of the Prepartum and Postpartum Eclampsia

作　　者：曹雯 喻红彪 周容 CAO Wen;YU Hongbiao;ZHOU Rong(Department of Obstetrics and Gynecology,West China Second University Hospital,Sichuan University,Key Laboratory of Birth Defects and Related Diseases of Women and Children,Ministry of Education,Chengdu Sichuan 610041,China)

机构地区：[1]四川大学华西第二医院妇产科出生缺陷与相关妇儿疾病教育部重点实验室,四川成都610041

出　　处：《实用妇产科杂志》2020年第5期373-379,共7页Journal of Practical Obstetrics and Gynecology

基　　金：国家自然科学基金(编号:81571465,81871175)。

摘　　要：目的:对产前子痫和产后子痫的临床特征进行分析,以探讨其发病机制及相关因素的不同。方法:回顾性分析2009年1月至2017年12月四川大学华西第二医院收治的子痫患者的临床资料,选择其中产前子痫组(67例)和产后子痫组(25例)为研究对象。比较两组患者的一般情况、临床表现、实验室检查指标及母儿结局。结果:①产前子痫组患者中年龄<25岁、未规律产检、低受教育程度、单胎所占比例明显高于产后子痫组,经产妇中两次分娩间隔时间短于产后子痫组,差异均有统计学意义(P<0.05)。②入院时和分娩时,产前子痫组中尿蛋白严重程度及病理管型的比例均高于产后子痫组(P<0.05);产前子痫组入院时白蛋白(ALB)降低、乳酸脱氢酶(LDH)升高的比例和肌酐(CR)的中位值明显高于产后子痫组(P<0.05)。分娩后仅产后子痫组LDH均值高于产前子痫组,差异有统计学意义(P<0.05)。③产前子痫组发病时舒张压升高、发生抽搐的次数及水肿所占比例明显高于产后子痫组(P<0.05)。④两组妊娠期糖尿病、合并心血管疾病、合并肾脏疾病等合并症和并发症比较,差异均无统计学意义(P>0.05)。⑤产前子痫组产后出血比例、胎盘重量、剖宫产术中出血量明显低于产后子痫组,新生儿出生体质量及1分钟、5分钟Apgar评分明显低于产后子痫组,差异有统计学意义(P<0.05)。结论:产前子痫患者的疾病严重程度及新生儿不良结局差于产后子痫组,产前及产后子痫患者的临床特征有明显不同,提示产后子痫的发病机制或许与产前子痫存在不同,应注重对两者的分别研究,以改善不良结局。Objective:To compare the differences in clinical characteristics and laboratory indictors between prepartum and postpartum eclampsia.Methods:The data of 92 eclampsia patients at the West China Second Hospital of Sichuan University from January 2009 to December 2017 were collected retrospectively,including 67 patients with prepartum eclampsia and 25 patients with postpartum eclampsia.The comparison of the two groups in baseline population characteristics,clinical manifestations,laboratory test results and maternal and fetal outcomes were performed.Results:①The proportion of patients in terms of age<25 years,irregular antenatal examinations,low education level,singleton pregnancy were significantly higher in the prepartum eclampsia group than postpartum eclampsia,and the interval between two deliveries was shorter than that in the postpartum eclampsia(P<0.05).②Comparing with the postpartum eclampsia group,the severity of urinary protein and the proportion of urine pathological cast in the prepartum eclampsia group were significantly higher(P<0.05),meanwhile,the value of lactate dehydrogenase(LDH)and creatinine(CR)on admission were higher whereas the albumin(ALB)was lower in prepartum eclampsia group,the differences were statistically significant(P<0.05).③Compared to the postpartum eclampsia group,blood pressure during eclampsia,frequency of convulsion and the scope of edema were significantly higher in prepartum eclampsia group(P<0.05).④There was no significant difference between the two groups in gestational diabetes mellitus,cardiovascular disease,kidney disease and other complications(P>0.05).⑤The proportion of postpartum hemorrhage,weight of placenta and the amount of blood loss during cesarean section were significantly lower in prepartum eclampsia group(P<0.05),and the birth weight and Apgar score of the newborn at 1 minute and 5 minutes were significantly lower in prepartum eclampsia group when compared to the postpartum eclampsia group(P<0.05).Conclusions:The severity of the disease and the advers

关 键 词：产前子痫 产后子痫 临床特征 实验室指标 母儿结局 

分 类 号：R714.245[医药卫生—妇产科学]