子痫前期患者水肿类型与妊娠不良结局的关系  

Correlation between Edema Types and Adverse Pregnancy Outcomes in Patients with Preeclampsia

作　　者：李慧静 顾洪旭 米春梅[1] LI Huijing;GU Hongxu;MI Chunmei(Department of Obstetrics,The Third Xiangya Hospital of Central South University,Changsha Hunan 410013,China)

机构地区：[1]中南大学湘雅三医院产科,湖南长沙410013

出　　处：《实用妇产科杂志》2024年第12期1019-1023,共5页Journal of Practical Obstetrics and Gynecology

基　　金：湖南省自然科学基金面上项目(编号:2020JJ4844)。

摘　　要：目的:分析子痫前期(PE)患者不同水肿类型母儿不良结局差异,探讨PE浆膜腔积液与低蛋白血症之间的关系。方法:选取2018年1月至2023年11月就诊于中南大学湘雅三医院PE患者120例进行回顾性分析,按水肿表现形式,分为无水肿(A型)、单纯组织间隙水肿(B型)、单纯腔隙水肿(单纯浆膜腔积液,C型)、混合水肿(组织间隙水肿与腔隙水肿并存,D型),分析不同水肿类型患者临床、实验室指标以及母儿不良结局的差异。随后按照腔隙积液量分为PE无腔隙积液组、PE少量腔隙积液组、PE中大量腔隙积液组,比较3组间母儿不良结局。结果:B型患者低蛋白血症占比最高(P<0.05),C型患者的血清白蛋白水平、24 h尿蛋白定量、血压、低蛋白血症占比与其余各型水肿患者两两比较均差异无统计学意义(P>0.05)。D型患者母儿不良结局发生率最高(P<0.05),以HELLP综合征及治疗性早产多见。按腔隙积液量分组后,PE少量腔隙积液组母儿不良结局发生率高于PE无腔隙积液组(P<0.05)。结论:浆膜腔积液患者,无论积液量多少,母儿结局差,需引起临床重视。Objective:To analyze the differences in adverse maternal-fetal outcomes among different types of edema in patients with pre-eclampsia(PE),and to explore the relationship between serous effusion and hypoproteinemia in PE.Methods:We retrospectively collected clinical data of 120 patients with pre-eclampsia who were treated in the Third Xiangya Hospital of Central South University from January 2018 to November 2023.The patients were divided into four groups based on the manifestation of edema:no edema(Type A),pure interstitial edema(Type B),pure cavity edema(pure serosal effusion,Type C),and mixed edema(both interstitial and cavity edema,Type D).Clinical and laboratory indicators as well as adverse maternal-fetal outcomes were analyzed among these groups.Subsequently,the patients were further divided into three groups according to the amount of serous cavity effusion:PE without effusion,PE with mild effusion,and PE with moderate to severe effusion.Adverse maternal-fetal outcomes were compared among these three groups.Results:Patients in Type B had the highest proportion of hypoalbuminemia(P<0.05).No statistically significant differences were found in serum albumin levels,24-hour urinary protein quantification,blood pressure,or the proportion of hypoalbuminemia between patients in Type C and those in other edema types(P>0.05).The incidence of adverse maternal-fetal outcomes was highest in Type D patients(P<0.05),with HELLP syndrome and therapeutic premature delivery being the most common.When grouped by the amount of cavity effusion,PE patients with mild effusion had a higher incidence of adverse pregnancy outcomes than those without effusion(P<0.05).Conclusions:Patients with serous cavity effusion,regardless of the effusion volume,have poor maternal-fetal outcomes and require clinical attention.

关 键 词：子痫前期 水肿 浆膜腔积液 妊娠不良结局 

分 类 号：R714.242[医药卫生—妇产科学] R714.244[医药卫生—临床医学]