早发型子痫前期不良妊娠结局的影响因素分析  

Analysis of influencing factors of adverse pregnancy outcome in early⁃onset preeclampsia

作　　者：季燕雯 陈先侠[1] 王海霞 卢晓倩 任俊娇 孙嘉敏 JI Yanwen;CHEN Xianxia;WANG Haixia;LU Xiaoqian;REN Junjiao;SUN Jiamin(Department of Emergency Obstetrics,Maternal and Child Health Care Hospital Affiliated to Anhui Medical University,Hefei 230001,China)

机构地区：[1]安徽医科大学附属妇幼保健院危急重产科,合肥230001

出　　处：《实用医学杂志》2020年第12期1590-1594,共5页The Journal of Practical Medicine

基　　金：安徽省2018年重点研究与开发计划(编号:1804h08020295)。

摘　　要：目的分析影响早发型子痫前期患者不良妊娠结局的高危因素,为临床预防及治疗母婴不良妊娠结局提供依据。方法回顾性分析111例早发型子痫前期孕产妇的临床资料,以孕产妇不良妊娠结局41例为研究组,余70例为对照组;以围产儿不良结局16例为研究组,余95例为对照组,采用Logistic回归分析两组患者的一般资料、各项生化指标和妊娠结局。结果(1)母体血肌酐Max及总蛋白Min水平是孕妇严重并发症发生的独立危险因素,OR值分别为0.956(95%CI:0.927~0.985,P=0.003)、1.171(95%CI:1.044~1.313,P=0.007);(2)慢性高血压并发子痫前期及母体D⁃二聚体Max水平是新生儿发生不良结局的独立危险因素,OR值分别为0.191(95%CI:0.051~0.709,P=0.013)、0.017(95%CI:0.676~0.963,P=0.807)。结论早发型子痫前期患者孕妇血肌酐Max及总蛋白Min水平与母体不良结局有关;慢性高血压并发子痫前期及母体D⁃二聚体Max水平明显升高与围产儿结局有关。因此在早发型子痫前期期待治疗中需严密监护,重点关注孕妇肝肾功能,定时产检监测血压和凝血功能,及时给予降压、抗凝等针对性治疗,降低并发症改善母婴结局。Objective To analyze high-risk factors affecting adverse pregnancy outcomes in patients with early-onset preeclampsia and provide evidence for clinical prevention and treatment of adverse pregnancy outcomes in mothers and infants.Methods The clinical data of 111 cases of women with early-onset preeclampsia were analyzed retrospectively,where 41 cases of maternal adverse pregnancy outcomes were as the study group,the remaining 70 cases were as the control group,16 cases of perinatal adverse outcome were as the study group,and the rest were as the control group including 95 cases.The general data,various biochemical indicators and pregnancy outcome of the two groups of patients were analyzed using Logistic regression.Results(1) Maternal serum creatinine Max and total protein Min were independent risk factors for severe complications in pregnant women,with OR values of 0.956(95%CI:0.9270.985,p=0.003) and 1.171(95%CI:1.044~1.313,P=0.007),respectively.(2) chronic hypertension complicated with preeclampsia and maternal D-dimer Max level were independent risk factors for adverse outcomes in newborns,with values of 0.191(95%CI:0.051~0.709,P=0.013) and 0.017(95% CI:0.676~0.963,P=0.807),respectively.Conclusions Serum creatinine Max and total protein Min in pregnant women with early-onset preeclampsia are related to adverse maternal outcomes.Chronic hypertension complicated with preeclampsia and significantly increasing maternal D-dimer Max levels were correlated with perinatal outcomes.Therefore,it is necessary to pay close monitoring and attention to the liver and kidney functions of pregnant women,monitor blood pressure and coagulation function by regular prenatal examination during the expectant treatment of early-onset preeclampsia and timely give targeted treatment such as hypotension and anticoagulation,thus reducing complications and improving maternal and infant outcomes.

关 键 词：早发型子痫前期 期待治疗 母婴结局 影响因素分析 

分 类 号：R714.2[医药卫生—妇产科学]