摘要
目的探讨早发型重度子痫前期的发病特点,为早期诊断、预测预后、选择适宜孕周终止妊娠提供临床依据。方法回顾性分析2009年1月至2011年6月重度子痫前期243例(早发型74例,晚发型169例)的一般情况、临床实验室指标、妊娠并发症及母婴结局,对早发型组不良妊娠结局的病例进行危险因素的Logistic多因素回归分析。结果两组孕妇平均年龄、孕次、产次、系统产检方面,差异无显著统计学意义(P>0.05),但两组入院孕周、分娩孕周、孕前身高体重指数差异有统计学意义;早发型组的白细胞计数、红细胞计数、血细胞比容、转氨酶水平、尿素氮、肌酐及舒张压均明显高于晚发型组,而血小板、血浆总蛋白均低于晚发型组,两组收缩压无明显差异;早发型组孕妇发生神经系统症状、消化系统症状、眼底改变、肝功能损害、低蛋白血症、胎盘早剥、心力衰竭及溶血、肝酶升高、血小板减少综合征的发生率均高于晚发型组;早发型组胎儿生长受限、胎儿窘迫、早产、新生儿死亡及死胎等发病率明显高于晚发型组;早发型重度子痫前期红细胞计数越高、血小板计数越低、转氨酶水平越高,越有可能出现母儿异常结局。结论掌握早发型重度子痫前期临床特点,积极预防预测不良妊娠结局的危险因素,找到母婴双方利益的平衡点,及时终止妊娠对改善母儿预后有重大意义。
Objective To Explore the clinical features of early-onset severe preeclampsia and provide clinical evidence for early diagnosis, prognosis and termination of pregnancy. Methods 243 cases of severe preeclampsia fromJanuary 2009 to June 2011 in Gulouhospital were derided into two groups： the early onset group （ n = 74） and the late onset group （ n = 169）. The general conditions, laboratory parameters, complications of pregnancy, outcomes of mothers and children were collected and the risk factors of adverse pregnancy out- comes of early-onset severe preeclampsia were analyzed by muhifactor Logistic regression. Results No signifi- cant differences were found between the two groups in the average age, gravidities, parities and systematically an- tenatal checks （ P 〉 0.05 ）, but significant differences were found in gestional ages at the onset of severe pre- eclampsia,delivery ages, and pregnant body mass index between the two groups. White blood cell count, red blood cell count, hematocrit, Alanine aminotransferase levels （ALT）, Urea nitrogen levels （BUN）, creatinine levels （Cr） ,and Diastolic blood pressure levels in the early onset group were significantly higher than those in the late onset group. The platelet count and Plasma total protein levels in the early onset group were significantly lower than those in the late onset group. No significant differences were found between the two groups in the Sys- tolic blood pressure levels. The incidence of nervous system symptoms, digestive system symptoms, fundus hem- orrhage, liver damages, hypoalbuminemia, palacental abruption, heart failure, and HELLP syndroms of mothers in the early onset group were significantly higher than those in the late onset group. The incidence of fetal growth retriction, fetal distress, premature delivery, newborns die and stillbirth in the early onset group were significantly higher than those in the late onset group. The higher red blood cell count, the lower platelet count and the higher alanine aminotransferas
出处
《东南国防医药》
2012年第3期209-212,共4页
Military Medical Journal of Southeast China
基金
江苏省"科教兴卫工程"医学重点学科(XK200709)
关键词
早发型重度子痫前期
红细胞计数
血小板计数
转氨酶
early-onset severe preeclampsia
red blood cell count
platelet count
alanine aminotrans- ferase
