妊娠期高血压疾病产妇产后合并心力衰竭危险因素分析及防治对策

目的探究妊娠期高血压疾病产妇产后合并心力衰竭(以下简称心衰)的危险因素及防治对策。方法回顾性分析2016年1月至2019年11月贺州市人民医院收治的578例妊娠期高血压疾病产妇的临床资料,根据产后是否合并心衰,分为合并心衰组(64例)和未出现心衰组(514例)。对两组年龄、体质量指数、生育史、心脏病史等资料进行对比分析,将其中有统计学差异的指标进行多因素Logistic回归分析,并分析其应对策略。结果单因素分析:两组心脏病史、糖尿病史、吸烟史、贫血、熬夜、感染、情绪激动、高脂血症、高尿酸血症、肾功能不全、左心室肥厚发生情况、氨基末端脑钠肽前体(N-terminalpro-brain natriuretic peptide,NTproBNP)水平、妊娠期高血压疾病类型、高血压病史时间、血压控制情况比较,差异有统计学意义(P<0.05)。Logistic回归分析:存在心脏病史、糖尿病史、吸烟史、贫血、熬夜、感染、情绪激动、高脂血症、高尿酸血症、肾功能不全、左心室肥厚、高NT-proBNP水平、子痫前期或子痫、血压控制较差等是妊娠期高血压疾病产妇产后合并心衰的独立危险因素,差异有统计学意义(P<0.05)。结论结合妊娠期高血压疾病产妇产后合并心衰的危险因素,改善心脏负荷,避免交感神经过度兴奋,积极治疗原发病,改掉不良习惯,重点监护子痫前期孕妇,降低妊娠期高血压疾病产妇产后心衰的风险。

Analysis of risk factors of postpartum complicated with heart failure in pregnant women with hypertension disease and preventive measures

Objective To explore the risk factors and preventive measures of postpartum heart failure(abbreviated as heart failure)in pregnant women with hypertension during pregnancy.Methods The clinical data of 578 pregnant women with hypertension during pregnancy from January 2016 to November 2019 in Hezhou People's Hospital were analyzed retrospectively.According to whether combined with heart failure,they were divided into heart failure group(64 cases)and non-heart failure group(514 cases).The age,body mass index,birth history,heart disease history and other data of the two groups were compared and analyzed,and the statistically significant indexes among them were analyzed by multivariate Logistic regression analysis.And analyzed its coping strategies.Results Single factor analysis:heart disease history,diabetes history,smoking history,anemia,staying up late,infection,emotional agitation,hyperlipidemia,hyperuricemia,renal insufficiency,occurrence of left ventricular hypertrophy,amino terminal brain natriuretic peptide,the level of precursor(N-terminalpro-brainnatriuretic peptide,NT-proBNP),type of pregnancy-induced hypertension,history of hypertension history,and blood pressure control of two groups were compared,and the differences were statistically significant(P<0.05).Logistic analysis:history of heart disease,diabetes,smoking,anemia,staying up late,infection,agitation,hyperlipidemia,hyperuricemia,renal dysfunction,left ventricular hypertrophy,high NT-proBNP levels,preeclampsia or eclampsia and poor blood pressure control were independent risk factors for postpartum heart failure associated with pregnancy-induced hypertension,and the differences were statistically significant(P<0.05).Conclusion Combined with the risk factors of postpartum heart failure in pregnant women with hypertension during pregnancy,improve heart load,avoid sympathetic nerve overexcitation,actively treat the original disease,change bad habits,focus on monitoring pre-eclampsia pregnant women,reduce maternal hypertension during pregnancy and postpartum risk of heart failure.