妊娠期容量负荷总体液评估与妊娠期高血压疾病的相关性研究  

Study on correlation between assessment of total fluid volume load during pregnancy and hypertensive diseases during pregnancy

作　　者：邵婕 王志坚 程莱 陆新妹 SHAO Jie;WANG Zhijian;CHEN Lai;LU Xinmei(Department of Obstetrics,Jiangsu Shengze Hospital Affiliated to Nanjing Medical University,Suzhou Jiangsu 215228,China)

机构地区：[1]南京医科大学附属江苏盛泽医院产科,江苏苏州215228

出　　处：《新疆医科大学学报》2024年第1期62-67,72,共7页Journal of Xinjiang Medical University

基　　金：苏州市吴江区“科教兴卫”项目(WWK201930)。

摘　　要：目的探讨妊娠期容量负荷总体液(Total body water,TBW)评估与妊娠期高血压疾病(Hypertensive disorder complicated pregnancy,HDCP)的相关性。方法选取2020年1月至2022年7月于南京医科大学附属江苏盛泽医院就诊的妊娠期高血压孕妇(n=30)、子痫前期孕妇(n=50)作为病例组(n=80),选择同期正常妊娠孕妇作为对照组(n=100);对比两组24 h尿钠、TBW、细胞外液(Extracellular water,ECW)和细胞内液(Intracellular water,ICW)水平以及对HDCP的预测价值。结果病例组妊娠早、中、晚期TBW、ECW、ICW水平均高于对照组[(40.42±5.45)L vs(36.98±5.61)L、(44.51±5.21)L vs(40.63±5.29)L、(47.76±5.84)L vs(44.07±5.78)L,(15.56±2.11)L vs(12.12±2.01)L、(17.45±2.46)L vs(13.97±2.28)L、(19.16±2.31)L vs(14.13±2.48)L,(29.88±1.03)L vs(27.39±1.04)L、(31.98±1.46)L vs(28.56±1.25)L、(36.56±1.11)L vs(32.12±1.01)L,P均<0.05];病例组妊娠早、中、晚期24 h尿钠水平均高于对照组[(109.16±8.94)mmol/d vs(95.77±7.78)mmol/d、(118.93±8.25)mmol/d vs(103.13±8.31)mmol/d、(133.67±8.45)mmol/d vs(108.08±8.33)mmol/d,P均<0.05]。子痫前期孕妇妊娠早、中、晚期TBW、ECW和ICW水平均高于妊娠高血压孕妇和对照组(P<0.05),妊娠期高血压孕妇妊娠早、中、晚期TBW、ECW和ICW水平均高于对照组(P<0.05),子痫前期孕妇妊娠早、中、晚期24 h尿钠水平均高于妊娠高血压孕妇和对照组(P<0.05);妊娠期高血压孕妇妊娠早、中、晚期24 h尿钠水平均高于对照组(P<0.05)。调整孕前BMI、年龄后,妊娠早、中期孕妇24 h尿钠水平(OR=2.180,95%CI:1.139~4.172;OR=2.088,95%CI:1.243~3.508)、TBW(OR=2.744,95%CI:1.885~3.994;OR=3.177,95%CI:2.106~4.792)、ECW(OR=1.015,95%CI:0.994~1.037;OR=1.077,95%CI:0.992~1.171)和ICW(OR=2.752,95%CI:1.886~4.015;OR=2.906,95%CI:1.691~4.994)均是HDCP的独立危险因素(P<0.05)。妊娠早期孕妇24 h尿钠水平、TBW、ECW和ICW预测HDCP的截断位分别为125.16 mmol/d、39.24 L、14.67 L、28.92 L,四者联合筛查时曲�Objective To explore the correlation between gestational capacity load assessment and the condition and prognosis of hypertensive disorder complicating pregnancy(HDCP).Methods From January 2020 to July 2022,pregnant women with pregnancy-induced hypertension(n=30)and pre-eclampsia(n=50)in the hospital were selected as case group(n=80)and normal pregnant women as control group(n=100).Compare the levels of 24-hour urinary sodium,maternal total body water(TBW),extracellular water(ECW),and intracellular water(ICW)between 2 groups,as well as their predictive value for HDCP.Results The levels of TBW,ECW,and ICW in the case group during early,middle,and late pregnancy were higher than those in the control group[(40.42±5.45)L vs(36.98±5.61)L,(44.51±5.21)L vs(40.63±5.29)L,(47.76±5.84)L vs(44.07±5.78)L,(15.56±2.11)L vs(12.12±2.01)L,(17.45±2.46)L vs(13.97±2.28)L,(19.16±2.31)L vs(14.13±2.48)L,(29.88±1.03)L vs(27.39±1.04)L,(31.98±1.46)L vs(28.56±1.25)L,(36.56±1.11)L vs(32.12±1.01)L,all P<0.05].The urinary sodium levels in the case group at 24 hours of early,middle and late pregnancy were higher than those in the control group[(109.16±8.94)mmol/d vs(95.77±7.78)mmol/d,(118.93±8.25)mmol/d vs(103.13±8.31)mmol/d,(133.67±8.45)mmol/d vs(108.08±8.33)mmol/d,all P<0.05].The overall fluid TBW,ECW and ICW levels in pregnant women with preeclampsia were higher than those in pregnant women with gestational hypertension and the control group(P<0.05).The overall fluid TBW,ECW and ICW levels in pregnant women with gestational hypertension were higher than those in the control group(P<0.05).The 24-hour urinary sodium levels in pregnant women with preeclampsia were higher than those in pregnant women with gestational hypertension and the control group(P<0.05).Pregnant women with gestational hypertension had higher urinary sodium levels at 24 hours in the early,middle and late stages of pregnancy compared to the control group(P<0.05).After adjusting for prepregnancy body mass index,age and 24-hour urinary sodium levels(OR=

关 键 词：细胞外液 尿钠排泄 妊娠期高血压疾病 容量负荷 

分 类 号：R715[医药卫生—妇产科学]