早发型与晚发型子痫前期母儿结局
|
摘要
目的对比分析重度子痫前期的临床资料,探讨早发型与晚发型子痫前期对母儿结局的影响。方法回顾性分析2013年1月-2017年12月伊犁州友谊医院收治的重度子痫前期患者260例,按照发病孕周分为早发型子痫前期(early-onset preeclampsia,E-PE)(孕周<34周),晚发型子痫前期(≥34周)。其中早发型154例;晚发型106例;对比二者的一般情况及孕妇的并发症及围产儿结局。统计学分析使用SPSS20.0。计量资料采用均数加减标准差,计数资料采用卡方检验或者连续校正公式。结果早发型子痫前期患者在收缩压及舒张压,发病孕周,终止孕周,期待治疗时间及有高血压家族史上,发病率高于晚发型,差异有统计学意义。E-PE围产儿结局在新生儿窒息,小于胎龄儿及新生儿死亡率上均大于晚发型,差异有统计学意义。结论早发型子痫前期孕妇发病早,病情重,母儿结局差。
ObjectiveTo Comparatively analyze the clinical data of severe preeclampsia and study on the influence of early onset and late onset preeclampsia on maternal and fetal outcomes.MethodsA retrospective analysis was conducted in 260 pregnant women with severe preeclampsia,who were admitted in the Department of Obstetrics of Youyi Hospital from January 2013 to December 2017.Severe preeclampsia were divided into early-onset severe pre-eclampsia group(E-SPE,154 cases)and late-onset preeclampsia group(106 cases)according to gestational weeks.Then the clinical data and perinatal outcomes between two groups were compared comprehensively.SPSS 20.0 was used.The metrological data are calculated by means plus or minus the standard deviation,and the counting data are calculated by chi-square test or continuous correction formula..Results The incidence of premature preeclampsia was higher than that of late onset in systolic and diastolic blood pressure(SBP),onset of gestational age,termination of gestational week,expectant treatment time and family history of hypertension.The difference was statistically significant(P<0.05).E-PE perinatal outcome was found in asphyxia neonatorum.The mortality rate of small gestational age infants and newborns was higher than that of late onset(P<0.05).ConclusionPregnant women with early preeclampsia have early onset,severe illness and poor maternal and fetal outcomes.
ObjectiveTo Comparatively analyze the clinical data of severe preeclampsia and study on the influence of early onset and late onset preeclampsia on maternal and fetal outcomes.MethodsA retrospective analysis was conducted in 260 pregnant women with severe preeclampsia,who were admitted in the Department of Obstetrics of Youyi Hospital from January 2013 to December 2017.Severe preeclampsia were divided into early-onset severe pre-eclampsia group(E-SPE,154 cases)and late-onset preeclampsia group(106 cases)according to gestational weeks.Then the clinical data and perinatal outcomes between two groups were compared comprehensively.SPSS 20.0 was used.The metrological data are calculated by means plus or minus the standard deviation,and the counting data are calculated by chi-square test or continuous correction formula..Results The incidence of premature preeclampsia was higher than that of late onset in systolic and diastolic blood pressure(SBP),onset of gestational age,termination of gestational week,expectant treatment time and family history of hypertension.The difference was statistically significant(P<0.05).E-PE perinatal outcome was found in asphyxia neonatorum.The mortality rate of small gestational age infants and newborns was higher than that of late onset(P<0.05).ConclusionPregnant women with early preeclampsia have early onset,severe illness and poor maternal and fetal outcomes.
引文
[1]Redman CW,Staff AC.Preeclampsia,biomarkers,syncytiotrophoblast stress,and placental capacity.Am J Obstet Gynecol[J].2015,213(4 Suppl):S9-11.
[2]杨孜,张为远.妊娠期高血压疾病诊治指南(2015)解读[J].中国实用妇科与产科杂志,2015,31(10):886-893.
[3]谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013:66-67.
[4]Bouthoorn SH,Gaillard R,Hofman A etal.Ethnic differences in blood pressure and hypertensive complications during pregnancy;the generation R Study.Pregnancy Hypertens[J].2012,2(3):195-97.
[5]Mbah AK1,Alio AP,Marty PJ etal.Recurrent versus isolated pre-eclampsia and risk of feto-infant morbidity outcomes:racial/ethnic disparity.Eur J Obstet Gynecol Reprod Biol[J].2011,156(1):23-8.
[6]李玲,陈洁,曲广弟.新疆哈萨克族重度子痫前期患者发病特点研究.新疆医科大学学报.[J]2013,36(9),1334-1340.
[7]李清阳,王芬,张颖143例临床资料分析新疆维吾尔族和汉族子痫前期及子痫病例.[J]2012,4(1),35-37.
[8]李春芳,苟文丽.妊娠期高血压疾病指南的变更与思考.中国计划生育和妇产科[J].2016,8(5):1-5.
[9]杨孜.多因素、多通路、多机制致病解子痫前期综合征制胜真实世界临床实践.中国实用妇科与产科杂志[J].2017.33(1).45-51.
[10]Nakagawa K,Lim E,Harvey S et al.Racial/Ethnic Disparities in the Association Between Preeclampsia Risk Factors and Preeclampsia Among Women Residing in Hawaii.Matern Child Health J[J].2016,20(9):1814-24.
[11]Samantha E.Parkera,Martha MPlacental Abruption and Subsequent Risk of Preeclampsia:A Population-Based Case-Control Study.Paediatr Perinat Epidemiol[J].2015,29(3):211-219.
[12]奴尔黑扎·巴哈夏别克,彭雪梅,李鹏等.新疆哈萨克族高血压病危险因素流行病学调查研究现状.新疆中医药[J].2016,34(2):64-66.
[13]富春花,张瑜萍,葛玉梅.哈萨克族人高血压病高发率的调查与研究.中国医药指南[J]2013,11(10):149-150.
[14]王林,李南方.饮食钙镁对高血压影响及预防.新疆医学[J].2018.48(2):202-203.
[15]张周斌薛振香汪慧等.新疆喀什地区维吾尔族人群糖尿病患病.中华流行病学杂志[J].2017年38(6)696-701.
[16]杨思进马依彤刘芬等.新疆维吾尔族、哈萨克族糖尿病的患病率调查及相关危险因素分析.中华内分泌杂志[J].2011,27(5):395-398.
[17]者炜,张文青,丁红等.维吾尔族常用传统食品和血糖生成指数测定.疾病控制杂志[J].2008,12(1):46-48.
[2]杨孜,张为远.妊娠期高血压疾病诊治指南(2015)解读[J].中国实用妇科与产科杂志,2015,31(10):886-893.
[3]谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013:66-67.
[4]Bouthoorn SH,Gaillard R,Hofman A etal.Ethnic differences in blood pressure and hypertensive complications during pregnancy;the generation R Study.Pregnancy Hypertens[J].2012,2(3):195-97.
[5]Mbah AK1,Alio AP,Marty PJ etal.Recurrent versus isolated pre-eclampsia and risk of feto-infant morbidity outcomes:racial/ethnic disparity.Eur J Obstet Gynecol Reprod Biol[J].2011,156(1):23-8.
[6]李玲,陈洁,曲广弟.新疆哈萨克族重度子痫前期患者发病特点研究.新疆医科大学学报.[J]2013,36(9),1334-1340.
[7]李清阳,王芬,张颖143例临床资料分析新疆维吾尔族和汉族子痫前期及子痫病例.[J]2012,4(1),35-37.
[8]李春芳,苟文丽.妊娠期高血压疾病指南的变更与思考.中国计划生育和妇产科[J].2016,8(5):1-5.
[9]杨孜.多因素、多通路、多机制致病解子痫前期综合征制胜真实世界临床实践.中国实用妇科与产科杂志[J].2017.33(1).45-51.
[10]Nakagawa K,Lim E,Harvey S et al.Racial/Ethnic Disparities in the Association Between Preeclampsia Risk Factors and Preeclampsia Among Women Residing in Hawaii.Matern Child Health J[J].2016,20(9):1814-24.
[11]Samantha E.Parkera,Martha MPlacental Abruption and Subsequent Risk of Preeclampsia:A Population-Based Case-Control Study.Paediatr Perinat Epidemiol[J].2015,29(3):211-219.
[12]奴尔黑扎·巴哈夏别克,彭雪梅,李鹏等.新疆哈萨克族高血压病危险因素流行病学调查研究现状.新疆中医药[J].2016,34(2):64-66.
[13]富春花,张瑜萍,葛玉梅.哈萨克族人高血压病高发率的调查与研究.中国医药指南[J]2013,11(10):149-150.
[14]王林,李南方.饮食钙镁对高血压影响及预防.新疆医学[J].2018.48(2):202-203.
[15]张周斌薛振香汪慧等.新疆喀什地区维吾尔族人群糖尿病患病.中华流行病学杂志[J].2017年38(6)696-701.
[16]杨思进马依彤刘芬等.新疆维吾尔族、哈萨克族糖尿病的患病率调查及相关危险因素分析.中华内分泌杂志[J].2011,27(5):395-398.
[17]者炜,张文青,丁红等.维吾尔族常用传统食品和血糖生成指数测定.疾病控制杂志[J].2008,12(1):46-48.