重度子痫前期渗出性视网膜脱离的影响因素分析及妊娠结局分析  

Analysis of influencing factors of severe preeclampsia with exudative retinal detachment and study of pregnancy outcome

作　　者：魏丹[1] 苏九妹[1] 高军[1] 安喜艳[1] 谈宗雯[1] 徐文君[1] Wei Dan;Su Jiumei;Gao Jun;An Xiyan;Tan Zongwen;Xu Wenjun(Department of Ophthalmology,The Third Central Hospital of Tianjin,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases,Artificial Cell Engineering Technology Research Center,Tianjin Institute of Hepatobiliary Disease,Tianjin 300170,China)

机构地区：[1]天津市第三中心医院眼科,天津市重症疾病体外生命支持重点实验室,天津市人工细胞工程技术研究中心,天津市肝胆疾病研究所,300170

出　　处：《中华眼底病杂志》2021年第5期371-376,共6页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察并初步探讨重度子痫前期(S-PE)患者合并渗出性视网膜脱离的影响因素及对妊娠结局的影响。方法2018年7月至2020年6月于天津市第三中心医院产科确诊为S-PE的89例患者纳入研究。根据是否合并渗出性视网膜脱离,将其分为网脱组、非网脱组,分别为43、46例。患者均行直接检眼镜检查,疑似及明确视网膜脱离者行光相干断层扫描或眼B型超声检查。收集患者年龄、病程、体重指数、收缩压、舒张压以及实验室血清白蛋白水平、24 h尿蛋白定量、血小板计数(PLT)、血小板平均体积、血小板分布宽度(PDW)、血清尿酸检查结果。两组患者平均年龄(t=-1.01)、体重指数(t=-1.799)、病程(t=-1.657)以及初产妇和经产妇构成比(χ^(2)=1.411)比较,差异均无统计学意义(P>0.05)。回顾分析患者结束妊娠时间、全身并发症、胎儿结局及新生儿Apgar评分情况。组间定量资料比较行独立样本t检验;定性资料比较行χ^(2)检验。二元logistic回归分析筛选S-PE发生渗出性视网膜脱离的影响因素。结果网脱组患者收缩压、舒张压均高于非网脱组,差异有统计学意义(t=2.087、2.810,P=0.040、0.006)。两组患者血清白蛋白(t=-10.404)、24 h尿蛋白定量(t=6.401)、血清尿酸(t=3.910)、PLT(t=-6.124)、PDW(t=2.992)比较,差异有统计学意义(P<0.05)。网脱组、非网脱组合并全身严重并发症分别为30(69.77%,30/43)、14(30.43%,14/46)例;结束妊娠平均时间分别为(34.66±3.29)、(38.25±1.62)周;新生儿出生时平均Apgar评分分别为(7.28±3.40)、(9.46±1.59)分。两组患者全身严重并发症发生率(χ^(2)=13.755)、结束妊娠时间(t=-6.448)、新生儿出生时Apgar评分(t=-3.824)比较,差异均有统计学意义(P=0.000、0.000、0.000)。网脱组、非网脱组胎儿窘迫、死亡分别为8(18.60%,8/43)、7(16.28%,7/43)例和7(15.22%,7/46)、1(2.17%,1/46)例。两组胎儿窘迫发生率比较,差异无统计学意义(χ^(2)=0.Objective To observe and preliminary investigate the influencing factors of exudative retinal detachment in patients with severe preeclampsia(S-PE)and its influence on pregnancy outcome.Methods A total of 89 patients of S-PE patients diagnosed in Department of Obstetrics in The Third Central Hospital of Tianjin from July 2018 to June 2020 were included in this study.According to whether the patients were complicated with exudative retinal detachment,they were divided into retinal detachment group(43 cases)and non retinal detachment group(46 cases).All patients underwent direct ophthalmoscopy,and those with suspected or definite retinal detachment underwent optical coherence tomography or B-mode ultrasonography.The age,course of disease,body mass index,systolic blood pressure,diastolic blood pressure,laboratory serum albumin level,24 h urinary protein,platelet count,mean platelet volume,platelet distribution width and serum uric acid content were collected.The average age(t=-1.01),body mass index(t=-1.799),course of disease(t=-1.657)and constituent ratio of primipara and multipara in the two groups were compared(χ^(2)=1.411),the difference was not statistically significant(P>0.05).The end of pregnancy time,systemic complications,fetal outcomes and neonatal Apgar scores were analyzed,retrospectively.Independent sample t test was used to compare the quantitative data between the two groups;Chi square test was used to compare qualitative data.Binary logistic regression analysis to screen the influencing factors of exudative retinal detachment in S-PE.Results Systolic blood pressure and diastolic blood pressure were higher in the retinal detachment group than in the non retinal detachment group,and the difference was statistically significant(t=2.087,2.810;P=0.040,0.006).Serum albumin(t=-10.404),24-hour urinary protein quantification(t=6.401),blood uric acid(t=3.910),platelet count(t=-6.124)and platelet distribution width(t=2.992)were compared between the two groups,and the differences were statistically significant(

关 键 词：先兆子痫 视网膜脱离 影响因素分析 

分 类 号：R714.244[医药卫生—妇产科学] R774.1[医药卫生—临床医学]