妊娠期高血压及轻度子痫前期疾病转归的相关因素研究

目的探讨影响妊娠期高血压及轻度子痫前期病情不同转归的相关危险因素。方法采用前瞻性病例对照研究方法，对诊断为妊娠期高血压及轻度子痫前期的165例孕妇的相关因素进行研究。根据初次诊断孕周分为A组和B组，对两组孕妇24h动态血压、血常规、24h尿蛋白、凝血功能、24h尿蛋白定量、谷丙转氨酶、血脂等临床数据进行统计学分析，观察在不同转归孕妇中这些指标的变化情况。结果A组和B组转归不良的发生率分别为60．6％（40／66）和18．2％（18／99），差异有统计学意义（P〈0．01）；A组孕妇的血白细胞、血红蛋白、24h尿蛋白定量、谷丙转氨酶的均值均高于B组，差异有统计学意义（P〈0．05）。A组峰值收缩压、峰值舒张压、峰值平均动脉压、夜间收缩压、夜间舒张压、夜间平均动脉压均值均高于B组，差异有统计学意义（P〈0．01）；而血清钙的均值则A组低于B组，差异有统计学意义（P〈0．01）。A组转归不良孕妇的IgA、尿素氮、血尿酸、转氨酶高于转归良好孕妇．差异有统计学意义（火O．05）。结论妊娠期高血压及轻度子痫前期孕妇起病时间越早，转归不良可能性越大；血清IgA、尿素氮、血尿酸、转氨酶、24h蛋白尿和24h动态血压等临床指标的升高可提示预后不良，应密切监测上述指标。适时进行干预，避免母胎不良预后。

A correlation study between gestational hypertension and mild preeclampsia gestational outcome

Objective Explore the relevant factors of gestational hypertension and mild pre-eclampsia pregnancy outcomes. Methods The case-control study was conducted among 165 patients with diagnosed gestational hypertension and mild pre-eclampsia. These pregnant womenwere divided into 2 groups： Group A （onset before 34 weeks） and group B （34- 36＋6 weeks）. After delivery,the group has been classed 2 groups according to the outcomes, Simultaneously, categorical variables were compared with use of chi-square analysis. The 24-hour ambulatory blood pressure,blood,24-hours proteinuria, coagulation, biochemical markers, and blood lipidswere analyzed. Results The adverse outcome was 60.6% （40/66）in the group A and 18.2% （18/99） in the group B （P〈0.01）. The levels of white blood cells, hemogloblin, urinary proteins and aspartate aminotransferase in Group A were higher than Group B patients （P〈0.05）.The peak systolic/diastolic blood pressure, the mean arterial pressure, night time systolic/diastolic blood pressure, and night time arterial pressure in the Group A patients were higher than the Group B patients （P〈0.01）. However, the level of serum calcium in group A patients was lower than the Group B patients （P〈0.01）. Conclusions We should pay more attention no the peak blood pressure, alanine aminotransferase, blood urea nitrogen, systolic blood pressure at night, night pulse pressure, andaspartate aminotransferase in the pregnant women with gestational hypertension or mild preeclampsia. Pregnant women with a poor predicted outcome may consider the termination of pregnancy, whereas patients with goodpredicted outcome should be closely monitored.