妊娠期高血压疾病患者尿蛋白成分与妊娠结局的关系

邓艳君　梁志冬　许宝莹　贾金平　秦江霞

【摘要】 目的：探討妊娠期高血压疾病患者尿蛋白成分与妊娠结局的关系。方法：回顾性分析2015年5月-2016年12月本院门诊产检的孕产妇的临床资料，选取出现妊娠期高血压疾病和蛋白尿的产妇120例为研究组，按照第一次监测出高血压的时间分为A组（<12周）、B组（12～28周）和C组（>28周），各40例；同期选取正常孕妇40例为对照组。比较四组入院准备分娩时尿液中蛋白成分；比较四组孕妇分娩结局和围生儿不良结局。结果：四组尿蛋白成分比较差异有统计学意义（字2=45.144，P=0.000）；四组剖宫产、ICP、胎盘早剥、羊水过多和产后出血比较，差异均有统计学意义（P<0.05）；四组死胎、早产、低出生体重儿及胎儿宫内窘迫比较，差异均有统计学意义（P<0.05）；剖宫产比例越高，出现ICP、胎盘早剥、羊水过多和产后出血比例越大，围生儿不良结局比例越高。结论：妊娠期高血压疾病出现时间越早的产妇，尿蛋白中大分子蛋白质含量越高，产妇和新生儿结局越差，提早对妊娠期高血压产妇的干预和监控，必要时可结束妊娠来减少围生期不良结局的出现。

【关键词】 妊娠期高血压疾病； 尿蛋白； 妊娠结局

Relationship between Urinary Protein Components and Pregnancy Outcome in Patients with Hypertensive Disorder Complicating Pregnancy/DENG Yanjun，LIANG Zhidong，XU Baoying，et al.//Medical Innovation of China，2018，15（12）：058-061

【Abstract】 Objective：To investigate the relationship between urinary protein components and pregnancy outcome in patients with hypertensive disorder complicating pregnancy.Method：The clinical data of pregnant women in our hospital from May 2015 to December 2016 were retrospectively analyzed，120 pregnant women with hypertension and proteinuria were selected as study group，according to the first monitoring of the time of hypertension，they were divided into A group（<12 weeks），B group（12-28 weeks） and C group（>28 weeks），40 cases in each group，and 40 cases of normal pregnant women in the same period were selected as control group.The urinary protein components in four groups at admission for delivery were compared，the outcomes of delivery and perinatal adverse outcomes in four groups were compared.Result：The urine protein components in four groups were compared，the difference was statistically significant（字2=45.144，P=0.000）.The cesarean section，ICP，placentalabruption，amniotic fluid and postpartum hemorrhagein of four groups were compared，the differences were statistically significant（P<0.05）.The fetal death，premature delivery，low birth weight infants and intrauterine fetal distress in four groups were compared，the differences were statistically significant（P<0.05）.The higher proportion of cesarean section，ICP，placental abruption，amniotic fluid excess and postpartum hemorrhage，the higher the proportion of perinatal adverse outcome.Conclusion：The higher the time of onset of hypertensive disorder complicating pregnancy，the higher the content of large molecular protein in urine protein，the worse the maternal and neonatal outcomes，the intervention and monitoring of maternal hypertension should be early，if necessary，the pregnancy can be terminated to reduce the occurrence of perinatal adverse outcomes.

【Key words】 Hypertensive disorder complicating pregnancy； Urinary protein； Pregnancy outcome

First-authors address：Huadu District Maternal and Child Health Care Hospital，Guangzhou 510800，China

doi：10.3969/j.issn.1674-4985.2018.12.017

隨着社会进步，生活压力不断加大，饮食结构的改变，近年来，妊娠期高血压疾病的发病率呈逐年上升的趋势[1]。妊娠期高血压疾病是发生在女性妊娠期的一种生理病理变化，以血压升高、出现水肿和蛋白尿为主要临床表现。妊娠期高血压疾病的出现主要是由于孕妇全身小动脉出现痉挛所致，对母婴均有较大危害，必须引起重视[2]。尤其是对低孕周就出现了高血压的孕妇来说，问题更加严峻，既要避免妊娠给孕妇造成的重要脏器损伤，又要避免早产对给新生儿带来的生命威胁[3]。因此研究孕期出现高血压的时间及尿蛋白的成分与妊娠结局的关系显得尤为必要。本问系统的研究孕期高血压出现的时间与尿蛋白成分和妊娠结局（包括分娩方式、孕妇并发症……