妊娠期高血压疾病临床特点的分析(1)
摘要：目的 通過分析妊娠期高血压疾病(hypertensive disorder complicating pregnancy，HDCP)患者的部分血液生化指标以及产前与产后42d血压变化的特点，提高对HDCP的预防和诊治水平，降低孕产妇的病死率，改善HDCP患者的远期预后。方法 采用回顾性研究的方法，选择282例HDCP患者并分为三组，其中妊娠期高血压组94例，轻度子痫前期组101例，重度子痫前期组87例，检测3组丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总蛋白(TP)、白蛋白(ALB)、尿素氮(BUN)、肌酐(CR)、尿酸(UA)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)，凝血酶原时间(PT)、活化部分促凝血酶原激酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D)、钙离子(Ca2+)水平并进行比较；观察HDCP患者产前与产后42d的血压变化，对3组的产后血压恢复率(产后42d血压恢复正常的人数与总人数的比值)进行比较；观察3组围产期并发症并进行比较。结果 3组间TP、ALB、CR、UA、PT、APTT、TT、FIB、D-D、TC、TG、LDL、Ca2+水平的差异均有统计学意义(P<0.05)，ALT、AST、BUN、HDL水平的差异均无统计学意义(P>0.05)。轻度子痫前期组的ALB、PT、TT、APTT、FIB、D-D、TC、TG、Ca2+水平与妊娠高血压组比较差异均有统计学意义(P<0.05)，重度子痫前期组的TP、ALB、CR、UA、PT、TT、FIB、D-D、TG、LDL、Ca2+水平与妊娠高血压组比较差异均有统计学意义(P<0.05)；重度子痫前期组的TP、ALB、UA、TT、APTT、FIB、D-D、TC、TG、LDL、Ca2+水平与轻度子痫前期组比较差异均有统计学意义(P<0.05)。3组间产后42天血压恢复率差异有统计学意义(P<0.05)。3组间并发症的比较，妊娠期高血压视网膜病变发生率有明显差异(P<0.05)。结论 HDCP3组间部分血液生化指标有明显差异，与HDCP患者的严重程度密切相关，可以作为评估HDCP患者病情严重程度的手段。HDCP患者产后42天血压大部分能恢复正常，但随着病情严重程度的加重，恢复率有所下降。并发症发病率有明显差异的是妊娠期高血压视网膜病变，提示早期进行眼底检查的重要性。
关键词：妊娠期高血压疾病；临床特点；生化指标
Abstract： Objective We analyse the HDCP patients’ varity of partial biochemical index and blood pressure of prenatal and postpartum 42 days. It can help us to improve HDCP patients prevention、treatment and reduce maternal fatality rate. It also can improve HDCP patients’ prognosis. Methods We used retrospective study method. There were 15378 cases from 2012 January to 2014 December in Nangtong maternal and child health hospital. There were 832 cases of HDCP among them. According to the standard to choose 282 cases of HDCP. Then divided them into three groups at random， 94 cases with gestational hypertension， 101 cases with mild preeclampsia， 87 cases with severe preeclampsia.We collect and analyse HDCP patients’ cliniacl data.Partial biochemical indexs ( ALT， AST， TP， ALB， BUN， CR， UA， TG， HDL， LDL， PT， APTT， TT， FIB， D-D， Ca2+ )， blood pressure of prenatal and postpartum 42 days were examined in three groups of pregnant women. We study them retrospectively. Results There are significant difference between three groups in TP， ALB， CR， UA， PT， APTT， TT， FIB， D-D， TC， TG， LDL， Ca2+ (p<0.05)， There are no significant difference between ALT， AST， BUN， HDL (P>0.05)； Compare to gestational hypertension：There are significant difference in ALB、PT、TT、APTT、FIB、D-D、TC、TG、Ca2+ of mild preeclampsia (p<0.05)，There are significant difference in TP、ALB、CR、UA、PT、TT、FIB、D-D、TG、LDL、Ca2+ of severe preeclampsia (p<0.05). Compare to mild preeclampsia：There are significant difference in TP、ALB、UA、TT、APTT、FIB、D-D、TC、TG、LDL、Ca2+ of severe preeclampsia (p<0.05). There are significant difference between three groups in blood pressure returned to normal in postpartum 42 days (p<0.05). Compare HDCP complication between three groups，there are significant difference in retinal disease (p<0.05). Conclusions There are significant difference between three groups in partial biochemical indexs. It’s closely relate to the severity of HDCP. We can use them to evaluate the severity of HDCP. Most of blood pressure returned to normal in postpartum 42 days. But as the disease progresses， the lower the rate. There are significant difference between three groups in retinal disease. It warns us the importance of early eyeground check examination., 百拇医药(刘文兵)
关键词：妊娠期高血压疾病；临床特点；生化指标
Abstract： Objective We analyse the HDCP patients’ varity of partial biochemical index and blood pressure of prenatal and postpartum 42 days. It can help us to improve HDCP patients prevention、treatment and reduce maternal fatality rate. It also can improve HDCP patients’ prognosis. Methods We used retrospective study method. There were 15378 cases from 2012 January to 2014 December in Nangtong maternal and child health hospital. There were 832 cases of HDCP among them. According to the standard to choose 282 cases of HDCP. Then divided them into three groups at random， 94 cases with gestational hypertension， 101 cases with mild preeclampsia， 87 cases with severe preeclampsia.We collect and analyse HDCP patients’ cliniacl data.Partial biochemical indexs ( ALT， AST， TP， ALB， BUN， CR， UA， TG， HDL， LDL， PT， APTT， TT， FIB， D-D， Ca2+ )， blood pressure of prenatal and postpartum 42 days were examined in three groups of pregnant women. We study them retrospectively. Results There are significant difference between three groups in TP， ALB， CR， UA， PT， APTT， TT， FIB， D-D， TC， TG， LDL， Ca2+ (p<0.05)， There are no significant difference between ALT， AST， BUN， HDL (P>0.05)； Compare to gestational hypertension：There are significant difference in ALB、PT、TT、APTT、FIB、D-D、TC、TG、Ca2+ of mild preeclampsia (p<0.05)，There are significant difference in TP、ALB、CR、UA、PT、TT、FIB、D-D、TG、LDL、Ca2+ of severe preeclampsia (p<0.05). Compare to mild preeclampsia：There are significant difference in TP、ALB、UA、TT、APTT、FIB、D-D、TC、TG、LDL、Ca2+ of severe preeclampsia (p<0.05). There are significant difference between three groups in blood pressure returned to normal in postpartum 42 days (p<0.05). Compare HDCP complication between three groups，there are significant difference in retinal disease (p<0.05). Conclusions There are significant difference between three groups in partial biochemical indexs. It’s closely relate to the severity of HDCP. We can use them to evaluate the severity of HDCP. Most of blood pressure returned to normal in postpartum 42 days. But as the disease progresses， the lower the rate. There are significant difference between three groups in retinal disease. It warns us the importance of early eyeground check examination., 百拇医药(刘文兵)