24 h不同尿蛋白水平子痫前期孕妇的临床特征及母婴结局分析  

Clinical Characteristics and Maternal and Infant Outcomes of Preeclamptic Pregnant Women with Different 24-hour Urinary Protein Levels

作　　者：张红霞[1] 刘昱[1] 安莉莉[1] 金丰梅[1] Zhang Hongxia;Liu Yu'an;Lily;Jin Fengmei(Department of Obstetrics and Gynecology,Zhuhai Maternal and Child Health Hospital,Zhuhai 519000,China)

机构地区：[1]珠海市妇幼保健院产科,广东珠海519000

出　　处：《中国医药指南》2023年第29期23-26,共4页Guide of China Medicine

摘　　要：目的 探讨子痫前期孕妇24 h不同尿蛋白水平的临床表现及母婴结局。方法 前瞻性选取珠海市妇幼保健院2015年6月至2023年1月期间珠海市妇幼保健院收治的202例子痫前期孕妇,患者入院后24 h尿蛋白水平均≥0.3g。根据尿蛋白水平的高低将其分为低水平组(0.3~2.0 g)97例、中水平组(2.0~5.0 g)47例和高水平组(≥5.0 g)58例。分析3组患者一般资料、实验室检查、临床表现及母婴结局差异。结果 随着24 h尿蛋白水平升高,年龄、ALT、AST、LDH、血肌酐、血尿酸、尿素水平及外周组织水肿、脐血流异常发生率均增高(均P <0.05);浆膜腔积液发生率高水平组高于低水平组和中水平组(均P <0.05)。高水平组胎儿生长受限、NICU入住率、新生儿窒息、新生儿呼吸窘迫综合征、新生儿坏死性小肠结肠炎、新生儿感染、黄疸、脑室内出血、新生儿贫血发生率均高于低水平组和中水平组,新生儿出生身长和新生儿出生体质量均小于低水平组和中水平组(均P <0.05)。结论 24 h不同尿蛋白水平子痫前期孕妇的临床特征及母婴结局均存在差异,水平越高,病情越严重,母婴结局越差。Objective To investigate the clinical manifestations and maternal and infant outcomes of pre-eclamptic pregnant women with different 24-hour urine protein levels.Methods This study prospectively included 202 cases of pregnant women with preeclampsia admitted to Zhuhai Maternal and Child Health Hospital between June 2015 and January 2023,with 24-hour urine protein levels ≥0.3 g.The patients were classified into 97 cases of low level group(0.3-2.0 g),47 cases of intermediate level group(2.0-5.0 g),and 58 cases of high level group(≥ 5.0g).The differences in general data,laboratory tests,clinical manifestations and maternal and infant outcomes among the three groups were analyzed.Results With the increase of 24-hour urine protein level,age,ALT,AST,LDH,blood creatinine,blood uric acid,urea level and the incidence of peripheral tissue edema and umbilical blood flow abnormalities increased(all P<0.05);the incidence of plasma viscera effusion was higher in the high-level group than that of the low-level group and intermediate-level group(both P<0.05).The incidence of fetal growth restriction,the percentage of admission to NICU,neonatal asphyxia,neonatal respiratory distress syndrome,neonatal necrotizing small intestinal colitis,neonatal infections,jaundice,intraventricular hemorrhage,and neonatal anemia were higher in the high-level group than in the low-and intermediate-level groups,and neonatal birth length and neonatal birth weight were smaller than that of the lowand intermediate-level groups(both P<0.05).Conclusions Clinical characteristics and maternal and infant outcomes of preeclamptic pregnant women with different 24-hout urinary protein levels differed,and the higher the level,the more severe the disease,the worse the outcome for mother and baby.

关 键 词：子痫前期 尿蛋白 病情严重程度 母婴结局 

分 类 号：R714.23[医药卫生—妇产科学]