摘要
目的研究24h尿蛋白定量及血清白蛋白水平在评估早发型重度子痫前期(EOSP)母儿妊娠结局的价值。方法回顾性分析于2012年1月至2015年12月收治温州市中西医结合医院的68例EOSP患者的临床资料,分别根据24h尿蛋白定量及是否合并低蛋白血症进行分组,比较两组患者期待治疗时间、并发症情况和围产儿结局。结果 (1)在期待治疗时间上,根据是否合并低蛋白血症分组,低蛋白血症组与非低蛋白血症组比较,差异有统计学意义(t=5.229,P<0.05);根据24h尿蛋白定量分组,<5g/24h组与≥5g/24h组比较,差异无统计学意义(t=0.760,P>0.05);(2)在患者并发症及围产儿结局的比较上,根据24h尿蛋白定量分组,<5g/24h组与≥5g/24h组比较差异均无统计学意义(均P>0.05);而根据是否合并低蛋白血症分组,非低蛋白血症组与低蛋白血症组肝功能损害、胎盘早剥、HELLP综合征、DIC、总并发症发生率,以及胎儿宫内窘迫、胎儿宫内生长受限(FGR)及新生儿窒息发生率比较差异均有统计学意义(χ~2值分别为11.588、4.566、5.479、6.774、11.619、3.951、4.573、4.830,均P<0.05);(3)分析EOSP患者不良结局的危险因素发现,发病孕周及血清白蛋白水平与母胎预后相关(OR值分别为1.043、0.170),差异均有统计学意义(均P<0.05),而与24h尿蛋白定量无统计学意义。结论 24h尿蛋白定量只能作为EOSP综合性评估预后的重要因素之一,对于合并低蛋白血症者,因病情急剧进展,并发症严重,应密切监测病情,积极处理,适时终止妊娠,以降低母胎不良预后。
Objective To investigate the value of 24h urinary protein quantitation and serum albumin level on maternal-fetal outcome evaluation of early onset severe preeclampsia （EOSP）.Methods Retrospective study was conducted on clinical documents of 68 patients with EOSP hospitalized in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2012 to December 2015.Patients were divided into two groups according to 24h urinary protein quantitation and combined with hypoalbuminemia or not.Expectant treatment time, complications and perinatal outcomes in two groups were compared.Results For expectant treatment time, statistically significant differences existed between two groups grouped with hypoalbuminemia or not （t=5.229, P〈0.05）, but there was no significant difference between group with urinary protein〈5g/24h and group with urinary protein≥5g/24h （t=0.760, P〉0.05）.For incidence of maternal-fetal complication and perinatal outcomes, difference between group with urinary protein〈5g/24h and group with urinary protein≥5g/24h was not significant （both P〉0.05）.But between two groups divided according to combination of hypoalbuminemia or not, differences in liver function damage, placental abruption, HELLP syndrome, DIC, incidence of overall complications, fetal distress, fetal growth restriction （FGR） and neonatal asphyxia incidence were statistically significant （χ2 value was 11.588, 4.566, 5.479, 6.774, 11.619, 3.951, 4.573 and 4.830 respectively, all P〈0.05）.Analysis on risk factors for adverse outcomes in EOSP patient revealed that gestational age of onset and serum albumin level were correlated with adverse pregnancy outcomes （OR value was 1.043 and 0.170, respectively）, and differences had statistical significance （both P〈0.05）.Quantity of 24h urinary protein was not statistically significant.Conclusion Urinary protein quantitation of 24h can be considered as one of important comprehensive assessment factors of EOSP prognosis.For EOSP patient
作者
梁辉标
陈丽平
LIANG Hui-biao CHEN Li-ping(Department of Obstetrics and Gynecology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang Chinese Medical University, Zhejiang Wenzhou 3：25000, Chin)
出处
《中国妇幼健康研究》
2017年第5期541-544,共4页
Chinese Journal of Woman and Child Health Research
关键词
早发型重度子痫前期
尿蛋白
低蛋白血症
期待治疗
early onset severe preeclampsia
urinary protein
hypoalbuminemia
expectant treatment
