HDP产妇产后发生慢性肾脏病风险因素  

Risk factors of postpartum chronic kidney disease of women with hypertensive disorders complicating pregnancy

作　　者：赵志新[1] 王瑞霞[1] 侯志飞 李媛 ZHAO Zhixin;WANG Ruixia;HOU Zhifei;LI Yuan(Shanxi Hospital of Traditional Chinese Medicine,Taiyuan,Shanxi Province,030000)

机构地区：[1]山西省中医院,太原030000

出　　处：《中国计划生育学杂志》2024年第2期396-400,共5页Chinese Journal of Family Planning

摘　　要：目的:分析妊娠期高血压疾病(HDP)发生产后慢性肾脏病(CKD)风险因素。方法:回顾分析2017年7月-2021年6月于本院建档产前检查的孕产妇病例记录共3185例,其中HDP产妇726例纳入观察组,非HDP产妇2459例纳入对照组。收集两组孕前情况、既往史、个人史、家族史、孕产史等临床资料,比较两组及产后发生CKD患者的临床资料,分析HDP产妇发生CKD的风险及相关风险因素。结果:观察组年龄和孕前体质指数高于对照组,初次妊娠、剖宫产及发生分娩并发症的比例高于对照组,CKD发病率(5.0%)高于对照组(1.4%)(均P<0.05)。经分析,观察组发生CKD的风险是对照组的5.54倍(95%CI3.43~10.65);HDP产妇矫正干扰因素后,分娩年龄≥35岁仍是CKD发生的风险因素(OR=2.31,95%CI1.30~3.89),分娩≥2次的HDP产妇发生CKD的风险低于初产妇(OR=0.34,95%CI0.14~0.74)(均P<0.05)。结论:HDP产妇发生CKD的风险较高,特别是年龄≥35岁的高龄产妇,提示临床在分娩后应嘱产妇定期检查肾功能,以便及时干预治疗。Objective:To analyze the risk factors of postpartum chronic kidney disease(CKD)of women with hyperten-sive disorders complicating pregnancy(HDPs).Methods:The maternal case records of 3185 women who had been giv-en antenatal examination in hospital from July 2017 to June 2021 were analyzed retrospectively,of which,726 women with HDPs were included in observation group and 2459 women without HDPs were included in control group.The clinical data,such as pre-pregnancy conditions,past medical history,personal history,family history and pregnancy and birth history of the women in the two groups were collected.The clinical data of the women with postpartum CKD were compared between the two groups.The risk and the risk factors of CKD occurrence of the women with HDPs were analyzed.Results:The age,the pre-pregnancy body mass index,and the proportions of the first pregnancy,ce-sarean section and childbirth complications of the women in the observation group were significantly higher than those of the women in the control group.The incidence of CKD(5.0%)of the women in the observation group was signifi-cantly higher than that(1.4%)of the women in the control group(all P<0.05).The risk of CKD of the women in the observation group was 5.54 times higher of that of the women in the control group(95%CI 3.43-10.65).After adjus-ting the confounding factors of the women with HDP,the age of the women at delivery≥35 years old was still a risk factor of their CKD occurrence(OR=2.31,95%CI 1.30-3.89).The risk of CKD occurrence of the women with HDP who gave birth≥2 times was significantly lower than that of the primiparas(OR=0.34,95%C10.14-0.74)(all P<0.05).Conclusion:The women with HDPs are in the high risk of developing CKD,,particularly those women≥35 years old,it is suggested that the renal function of the women with HDPs should be checked regularly after delivery,so as to intervene and treat in time.

关 键 词：妊娠期高血压疾病 慢性高血压 子痫前期 慢性肾脏病 风险因素 

分 类 号：R692[医药卫生—泌尿科学] R714.246[医药卫生—外科学]