妊娠期肾病综合征62例临床特点及围生结局分析

目的:分析妊娠期肾病综合征的临床特点及其围生结局。方法:回顾性分析2009年1月至2010年12月在湘潭市妇幼保健院住院的273例重度子痫前期患者,将62例妊娠期肾病综合征和随机选择的70例重度子痫前期无合并肾病综合征患者分别作为肾病组和对照组,分析两组临床资料,比较血压、低蛋白血症情况、肾功能指标和围生结局。结果:肾病组多为年龄较轻的初产妇,病情重,以舒张压升高为主。肾病组血浆总蛋白和白蛋白低于对照组(P<0.05);24小时尿蛋白定量、尿素氮和肌酐均高于对照组(P<0.05)。肾病组早产率、小于胎龄儿发生率、围生儿死亡率和新生儿并发症发生率高于对照组,差异均有统计学意义(P<0.05)。结论:妊娠期肾病综合征病情重、进展快,对母婴的影响大,适时终止妊娠可减少妊娠期并发症及围生儿发病率和死亡率。

Clinical Feature and Perinatal Outcomes of 62 Cases with Nephritic Syndrome of Pregnancy

Objective:To analyze the clinical feature and perinatal outcomes of nephritic syndrome of pregnancy(NSP).Methods:273 pregnant women with severe preeclampsia who were hospitalized in Maternal and Child Health Hospital of Xiangtan City from January 2009 to December 2010 were retrospectively analyzed.The patients were divided into two groups according to preeclampsia with nephritic syndrome or without nephritic syndrome:nephritic group included 62 cases,and control group included 211 cases.Clinical data including blood pressure,hypoproteinemia situation,biochemical indicators and perinatal outcomes were compared between two groups.Results:NSP was more likely to happen in younger primipara,with severely increased diastolic pressure.The serum total protein and albumin in NSP group were lower than control group(P<0.05).Duantitation of urine protein for 24 hours,urine nitrogen and creatinine in NSP group were higher than control group(P<0.05).The preterm delivery rate,incidence of fetus with small for gestational age,perinatal death rate and incidence of neonatal complication were higher in NSP group than control group.There was obvious statistical difference(P<0.05).Conclusions:NSP has large effects on mother and fetus with severe condition and quick development.Termination of pregnancy at time can reduce perinatal complications,perinatal morbidity and mortality.