新疆维、汉族重度子痫前期孕妇器官受累特点与围产儿预后的关系

目的:探讨新疆维吾尔族与汉族重度子痫前期孕妇器官受累特点及其与围产儿预后的关系。方法:回顾性分析297例重度子痫前期患者的临床资料。将重度子痫前期患者按民族分为维族和汉族。分析比较2组患者的一般临床数据、器官受累和并发症发生情况及围产儿结局。结果:297例重度子痫前期患者中,119例存在器官受损,维、汉两族患者均以单器官损害为主,维族患者器官损害以胎盘和肾脏损害为主,汉族则以胎盘、心脏和视网膜损害为主。两脏器受损患者中,汉族以胎盘并子痫及胎盘并DIC为主,维族以胎盘并肾损害为主。多器官受损患者中,维、汉族无明显差异。器官受损维族患者的围产儿死亡率较汉族高,差异有统计学意义。多因素Logistic回归分析,胎儿及新生儿死亡与孕妇器官受损的数量有关,两器官和多器官受损的胎儿及新生儿死亡率高于单器官受累者,且以维族患者明显。结论:重度子痫前期的器官受损在维族和汉族之间有明显的不同,个体及民族之间的多因素和多基因可能决定着不同的病理机制。

The clinical features and the relationship of the organ damage of severe preeclampsia and perinatal outcomes between Uygurs and Hans in Xinjiang

Objective:To study the clinical features and the relationship of the organ damage of severe preeclampsia(S-PE)and perinatal outcomes between Uygurs and Hans in Xinjiang.Methods:297 pregnant women with S-PE cases were divided into two groups according to different ethnicity:Uygurs group(n=124)and Hans group(n=173).The clinical data were evaluated.The relationship between the pattern of organ damage,maternal outcomes,perinatal mortality and morbidities were analyzed.Results:Most of the S-PE cases who have organs damage had single organ systemic damage.In Uygur cases placenta and kidney were the top two organs which was affected singly,but in Han cases the top three were placenta,heart and retina.In those cases who have two internal organs damaged,Han nationality cases were placenta and eclampsia and placenta combined DIC primarily,Uygur nationality cases were placenta combined kidney harm primarily.In multi-organ damage patient,Uygur,Han nationalities had no obvious difference.The perinatal mortality of Uygur nationality minority cases was significantly higher than that of Han nationality's.In multi-factor logistic regression analysis,we found mother's affected organs,those whose mother were affected by two or more organ damage had significantly higher mortality,especially in Uygurs.Conclusion:There is significant difference in the type of organ damage between Uygurs and Han women with severe preeclampsia.The individual,the nationality's multi-factors and the polygenes possibly induce the different pathology mechanism.