子痫前期孕妇尿微量白蛋白/肌酐比值与病情程度和妊娠结局  

Correlation of urine microalbumin/creatinine ratio of pregnant women with preeclampsia and their severity of preeclampsia and pregnancy outcomes

作　　者：夏姣 颜红梅 陈会霞 王莉桦 李海燕 XIA Jiao;YAN Hongmei;CHEN Huixia;WANG Lihua;LI Haiyan(Guang'an People's Hospital,Guang'an,Sichuan Province,638000)

机构地区：[1]四川省广安市人民医院,638000

出　　处：《中国计划生育学杂志》2022年第3期707-710,共4页Chinese Journal of Family Planning

摘　　要：目的:探究子痫前期(PE)孕妇尿微量白蛋白/肌酐比值(ACR)水平变化,分析与患者病情严重程度、不良妊娠结局的相关性。方法:收集2019年3月-2021年3月本院收治的PE患者280例为PE组,根据ACR水平分为高ACR组(n=147)和低ACR组(n=133),同期妊娠正常孕妇280例为对照组,比较PE组和对照组、PE组中不同严重程度患者的平均动脉压、24h尿蛋白量和ACR水平,随访PE组妊娠结局。结果:PE组24h尿蛋白量(0.36±0.09 g)、ACR(73.52±12.73 mg/mmol)和平均动脉压(112.75±8.96 mmHg)均高于对照组(0.07±0.02 g、20.83±4.65 mg/mmol、96.37±5.18 mmHg)且重度PE患者高于轻度PE患者(均P<0.05)。多元线性回归分析显示,PE患者的ACR水平与24h尿蛋白量、平均动脉压呈明显正相关(P<0.05)。高ACR组羊水污染≥Ⅲ度(21.1%)、早产或引产(89.1%)、胎儿死亡(14.3%)、胎盘早剥(6.8%)和胎儿宫内窘迫(17.7%)发生率均高于低ACR组(9.0%、75.9%、6.0%、0.8%、9.0%)(P<0.05)。结论:PE患者ACR水平偏高且与病情严重程度及不良妊娠结局发生相关,临床应加以监测。Objective:To explore the changes of urine microalbumin/creatinine ratio(ACR)of pregnant women with preeclampsia(PE),and to analyze their correlation with the severity of preeclampsia and the pregnancy outcomes of these women.Methods:280 pregnant women with PE were collected in study group,and were divided in group A(n=147 women with high ACR)and group B(n=153 women with low ACR)according to the ACR value between March 2019 and March 2021.Meanwhile,280 normal pregnant women were selected in control group.The values of mean arterial pressure,24-hour urine protein content,and ACR value of the women were compared between the study group and the control group and among the women with different severity of PE.The pregnancy outcomes of the women in the study group were followed up.Results:The 24 h urinary protein content(0.36±0.09 g),and the values of ACR(73.52±12.73 mg/mmol)and the mean arterial pressure(112.75±8.96 mmHg)of the women in the study group were significantly higher than those(0.07±0.02 g,20.83±4.65 mg/mmol,and 96.37±5.18 mmHg)of the women in the control group,and which of the women with severe PE were significantly higher than those of the women with mild PE(all P<0.05).Multiple linear regression analysis showed that the ACR value of the women with PE was significantly positively correlated with their 24 h urinary protein content and their mean arterial pressure value(P<0.05).The incidences of amniotic fluid contamination≥Ⅲ(21.1%),premature or induced labor(89.1%),fetal death(14.3%),placental abruption(6.8%),and fetal intrauterine distress(17.7%)of the women in group A were significantly higher than those(9.0%,75.9%,6.0%,0.8%,and 9.0%)of the women in group B(P<0.05).Conclusion:The ACR value of the pregnant women with PE is higher,which is related to their severity of PE and their adverse pregnancy outcomes,so which should be monitored in clinic.

关 键 词：子痫前期 疾病严重程度 尿微量白蛋白 尿肌酐 不良妊娠结局 

分 类 号：R714.244[医药卫生—妇产科学]