妊娠期高血压疾病发生器官或系统受累高危因素的区域性分析  

Regional analysis of high risk factors of hypertensive disorders in pregnancy with organ or system impairment

作　　者：吕鑫 张为远[2] 张靖霄[3] 魏玉茜 郭晓丽 崔世红[6] 颜建英[7] 张孝艳[8] 乔宠[9] 周容 顾蔚蓉 陈先侠 杨孜[13] 李笑天 林建华[1] Lyu Xin;Zhang Weiyuan;Zhang Jingxiao;Wei Yuqian;Guo Xiaoli;Cui Shihong;Yan Jianying;Zhang Xiaoyan;Qiao Chong;Zhou Rong;Gu Weirong;Chen Xianxia;Yang Zi;Li Xiaotian;Lin Jianhua(Department of Obstetrics and Gynecology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Department of Obstetrics,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China;Department of Obstetrics and Gynecology,the Fourth Hospital of Shijiazhuang,Shijiazhuang 050035,China;Department of Obstetrics and Gynecology,Affiliated Hospital of Jining Medical University,Jining 272007,China;Department of Obstetrics,Changzhi Maternity and Child Health Care Hospital of Shanxi Province,Changzhi 046000,China;Department of Obstetrics and Gynecology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450015,China;Department of Obstetrics,Fujian Maternity and Child Health Care Hospital,Fuzhou 350005,China;Department of Obstetrics and Gynecology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Obstetrics and Gynecology,Shengjing Hospital of China Medical University,Shenyang 117004,China;Department of Obstetrics,West China Second University Hospital,Sichuan University,Chengdu 610044,China;Department of Obstetrics,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200082,China;Department of Obstetrics,Anhui Province Maternity and Child Health Hospital,Hefei 230001,China;Department of Obstetrics and Gynecology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]上海交通大学医学院附属仁济医院妇产科,上海200127 [2]首都医科大学附属北京妇产医院产科,北京100026 [3]石家庄市第四医院妇产科,石家庄050035 [4]济宁医学院附属医院妇产科,济宁272007 [5]山西省长治市妇幼保健院产科,长治046000 [6]郑州大学第三附属医院妇产科,郑州450015 [7]福建省妇幼保健院产科,福州350005 [8]郑州大学第一附属医院妇产科,郑州450052 [9]中国医科大学附属盛京医院妇产科,沈阳117004 [10]四川大学华西第二医院产科,成都610044 [11]复旦大学附属妇产科医院产科,上海200082 [12]安徽省妇幼保健院产科,合肥230001 [13]北京大学第三医院妇产科,北京100191

出　　处：《中华妇产科杂志》2023年第6期416-422,共7页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的探讨妊娠期高血压疾病(HDP)孕妇伴发器官或系统受累的影响因素,分析比较全国各地区HDP类型的差异。方法收集全国24个省、自治区、直辖市的161家医院2018年1月1日至12月31日资料完整的HDP孕妇27680例,根据其临床表现分为单纯血压升高组[共10308例,包括妊娠期高血压(GH)8250例、妊娠合并慢性高血压2058例]、伴器官或系统受累组[共17372例,包括子痫前期(PE)14590例、子痫137例、慢性高血压伴发PE 2645例]。回顾性分析华东(6136例)、华北(4821例)、华中(3502例)、华南(8371例)、东北(1456例)、西南(2158例)、西北(1236例)七大地区HDP的类型分布,通过对比各地区HDP类型的差异及其相关高危因素,对HDP孕妇伴器官或系统受累的危险因素进行区域性分析。结果(1)东北(79.05%,1151/1456)、华中(68.42%,2396/3502)、西北(69.34%,857/1236)地区HDP孕妇伴器官或系统受累的占比高于全国平均水平(62.76%,17372/27680);华北(59.18%,2853/4821)、华东(60.85%,3734/6136)及华南(59.56%,4986/8371)地区HDP孕妇伴器官或系统受累的占比低于全国平均水平;分别比较,差异均有统计学意义(P均<0.05)。(2)单因素分析结果显示,初产妇、非汉族、非城市户籍、不规范产前检查(产检)、PE病史在伴器官或系统受累组中的占比高于单纯血压升高组,分别比较,差异均有统计学意义(P均<0.05);经多因素logistic回归分析,初产妇、非汉族、非城市户籍、不规范产检、PE病史是影响HDP孕妇伴器官或系统受累的独立风险因素(P均<0.05)。(3)初产妇占比:东北、华北、西南地区高于全国平均水平,华南、华中、西北地区低于全国平均水平;非汉族率:东北、华北、西北地区高于全国平均水平,华东、华南、华中地区低于全国平均水平;非城市户籍率:东北、华北、西南地区低于全国平均水平,华东、华中地区高于全国平均水平;不规范产检率:华北、华南、西南地�Objective To explore the influencing factors of pregnancy-induced hypertensive disorders in pregnancy(HDP)with organ or system impairment in pregnant women,and to analyze and compare the differences of HDP subtypes in different regions of China.Methods A total of 27680 pregnant women with HDP with complete data from 161 hospitals in 24 provinces,autonomous regions and municipalities were retrospectively collected from January 1,2018 to December 31,2018.According to their clinical manifestations,they were divided into hypertension group[a total of 10308 cases,including 8250 cases of gestational hypertension(GH),2058 cases of chronic hypertension during pregnancy]and hypertension with organ or system impairment group[17372 cases,including 14590 cases of pre-eclampsia(PE),137 cases of eclampsia,2645 cases of chronic hypertension with PE].The subtype distribution of HDP in East China(6136 cases),North China(4821 cases),Central China(3502 cases),South China(8371 cases),Northeast China(1456 cases),Southwest China(2158 cases)and Northwest China(1236 cases)were analyzed.By comparing the differences of HDP subtypes and related risk factors in different regions,regional analysis of the risk factors of HDP pregnant women with organ or system impairment was conducted.Results(1)The proportions of HDP pregnant women with organ or system impairment in Northeast China(79.05%,1151/1456),Central China(68.42%,2396/3502)and Northwest China(69.34%,857/1236)were higher than the national average(62.76%,17372/27680);the proportions in North China(59.18%,2853/4821),East China(60.85%,3734/6136)and South China(59.56%,4986/8371)were lower than the national average,and the differences were statistically significant(all P<0.05).(2)Univariate analysis showed that the proportions of primiparas,non-Han,non-urban household registration,irregular prenatal examination and PE history in the hypertension with organ or system impairment group were higher than those in the hypertension group,and the differences were statistically significant(all P<0.05

关 键 词：高血压 妊娠性 先兆子痫 危险因素 

分 类 号：R714.246[医药卫生—妇产科学]