妊娠期高血压和子痫前期对肾脏功能的长期影响

目的:评估妊娠期高血压(GH)和子痫前期(PE)对肾脏功能的长期影响。方法:回顾性分析本院2013年1月—2015年8月3 583例GH(GH组)、811例PE(PE组)和10 457例健康(对照组)初产妇的临床资料。随访2年,比较3组孕妇慢性肾脏病(CKD)、肾病入院等情况。结果:GH和PE初产孕妇的CKD发生率分别为5.2%(188/3 583)和7.5%(61/811),对照组CKD发生率为3.9%(405/10 457)。校正前PE组CKD危险比为2.02(95%CI:1.53~2.67),GH组为1.37(95%CI:1.15~1.64);校正年龄、产龄、体质量指数(BMI)、文化程度和吸烟状况后,CKD危险比分别为1.92(95%CI:1.45~2.56)和1.36(95%CI:1.14~1.63)。Logistic回归分析显示,PE组CKD危险比高于GH组,且两组CKD危险比、肾病入院危险比皆高于对照组(危险比为1)。结论:GH和PE增加了初产孕妇的CKD风险,发病早于血压正常初产孕妇。

Long-term Effect of Gestational Hypertension and Pre-eclampsia on Kidney Function

Objective:To assess the long-term effect of gestational hypertension and pre-eclampsia on the renal function. Methods: Retrospective study were designed i n those primipara, including 3583 cases of gestational hypertension (GH group), 811 cases of pre-eclampsia (PE group) and 10457 cases of normotensive (the control group), from January 2013 to August 2015. The occurrence rates of chronic kidney disease (CKD) and hospital admission related to kidney diseases within two years of follow-up visit were compared. Results: The rates of CKD in the PE group, GH group and the control group were 7.5% (61/811), 5.2% (188/3583) and 3.9%(405/10457), respectively. The unadjusted odds ratios (95%confidence interval) of CKD were 2.02 (95%CI:1.53~2.67) in the PE group and 1.37 (95%CI:1.15-1.64) in the GH group. This ratio was then adjusted for age and year at delivery, BMI, degree of education and smoking status in present study. The adjusted odds ratios were 1.92 (95%CI: 1.45-2.56) and 1.36 (95%CI: 1.14-1.63) in two groups. Logistic regression analysis showed that the risk ratio of CKD in the PE group was higher than that in the GH group. The risk ratios of CKD and the rates of renal disease admission in the PE group and GH group were higher than those in the control group. Conclusions:The risk of CKD was increased in those women undergone GH and PE, while CKD was diagnosed earlier.