摘要
目的研究高龄二胎妊娠期高血压产妇的动态血压、动态心电图特点,探讨其在妊娠期高龄二胎产妇中诊疗价值。方法回顾性分析2020年6月至2021年6月在华南理工大学附属第六人民医院规律产检并住院分娩的妊娠期高血压二胎产妇300例,按照孕妇年龄分为高龄组(年龄≥35岁,n=150)、适龄组(年龄<35岁,n=150)。所有孕妇于妊娠中晚期行24小时动态血压、动态心电图检查,比较两组指标的差异及不良结果的关系。结果高龄组的血压变异性均高于适龄组,心率变异性均低于适龄组,差异有统计学意义。早产、胎儿窘迫、新生儿窒息、Hellp综合征、胎儿畸形、足月低体重儿在高龄组的发生率均高于适龄组,差异有统计学意义(p<0.05)。血压变异性指标及24小时尿蛋白、BMI(身体质量指数)、LMR(淋巴细胞和单核细胞的比值)与不良妊娠结果相关性分析,呈正相关(p<0.05)。结论高龄二胎孕妇妊娠期高血压更容易发生,血压变异性指标,24小时尿蛋白及LMR(淋巴细胞和单核细胞的比值)与不良妊娠结果具有正相关。因此对妊娠期二胎高龄孕妇常规性行动态心电图及动态血压监测有重要的临床指导意义,能有效地提高高龄二胎妊娠期高血压孕妇围产期监测效果。
Objective To study the characteristics of ambulatory blood pressure and ambulatory electrocardiogram in senile parturient with hypertension during second-pregnancy,and to explore their diagnostic and therapeutic value.Methods A retrospective analysis was performed in 300 pregnant women with gestational hypertension who were admitted to the Sixth People’s Hospital affiliated to South China University of Technology from June 2020 to June 2021.According to the age of pregnant women,they were divided into the advanced age group(≥35 years old,n=150)and the appropriate age group(<35 years old,n=150).All the pregnant women underwent24-hour ambulatory blood pressure and ambulatory electrocardiogram in the middle and late stages of pregnancy to compare the difference of the two groups of indicators and the relationship between adverse outcomes.Results The blood pressure variability of the aged group was higher than that of the age-appropriate group,and the heart rate variability was lower than that of the age-appropriate group,with statistically significant differences.The incidence of preterm birth,fetal distress,neonatal asphyxia,Hellp syndrome,fetal malformation and full-term low birth weight infants in the older group were higher than those in the appropriate age group,and the difference was statistically significant(p<0.05).Blood pressure variability,24h urine protein,BMI(body mass index),LMR(lymphocyte to monocyte ratio)and adverse pregnancy outcome were positively correlated(p<0.05).Conclusions Gestational hypertension is more likely to occur in older pregnant women with second trimester,and blood pressure variability,24-hour urinary protein and LMR(ratio of lymphocytes to monocytes)are positively correlated with adverse pregnancy outcomes.Therefore,routine sexual dynamic electrocardiogram and ambulatory blood pressure monitoring have important clinical guiding significance for older pregnant women with second trimester.It can effectively improve the perinatal monitoring effect of elderly pregnant women with hy
作者
蒋子裕
陈楚雯
Jiang ziyu;Chen chuwen(Deparment of Pediarics,The Sixth People's Hospital Afiliated to South China University of Technology,Foshan,528200,China)
出处
《临床心电学杂志》
2022年第3期191-194,共4页
Journal of Clinical Electrocardiology
关键词
二胎妊娠
动态心电图
动态血压
The second pregnancy
Dynamic electrocardiogram
Ambulatory blood pressure
