妊娠期高血压综合征的预后因素分析

目的 探讨不同因素对罹患妊娠期高血压综合征(妊高症)孕妇预后及围生儿的影响.方法 入组妊高症患者及正常产妇各173例,记录年龄、受教育年限,测量血钙、血镁、血清脂联素、平均收缩压、平均舒张压,同时记录分娩方式、孕妇并发症及围生儿状况,做两组间比较.在研究组内采用多因素分析,分析8种不同因素对妊高症预后的影响.结果 (1)研究组的围生儿窒息、胎儿窘迫、早产、尿酸、平均收缩压、平均舒张压高于对照组,研究组的血钙、血镁、血清脂联素显著低于对照组.低体重儿、产后出血、剖宫产在20～35岁年龄的孕妇中研究组多于对照组.(2)尿酸浓度影响围生儿窒息、早产、低体重儿(SE=0.359、0.621、0.486,P＜0.05);血钙浓度影响胎儿窘迫、胎盘早剥(SE=0.361、0.473,P＜0.05),血镁浓度影响围生儿死亡(SE=0.732,P＜0.05);血清脂联素水平影响产后出血(SE=0.348,P＜0.05);平均舒张压和平均收缩压影响胎儿窘迫、胎盘早剥、剖宫产(P＜0.05);受教育年限和年龄影响剖宫产(SE=0.441、0.651,P＜0.05).结论 妊高症的预后与年龄、受教育年限、血压、血钙、血镁、尿酸、血清脂联素密切相关.

Analysis on prognosis factors of pregnant women with pregnancy hypertension

Objective To investigate the different factors on pregnant women and perinatal outcome of children suffering from pregnancy hypertension. Methods There were 173 cases both in the group of patients with pregnancy hypertension and in the normal mothers. The age, years of education would be recorded. The serum calcium, serum magnesium, serum adiponectin, the average systolic blood pressure, the mean diastolic blood pressure would be measured. The mode of delivery, maternal complications and perinatal children status were also recorded. The result was compared between the two groups. The multivariate analysis was used in the study group to analysis the influence of the prognosis of pregnancy hypertension on 8 different factors. Results （ 1 ） The numbers of children perinatal asphyxia, fetal distress, premature delivery, uric acid, the average systolic blood pressure, diastolic blood pressure of the study group were higher than the normal group. The numbers of serum calcium, serum magnesium, serum adiponectin of the study group ware significantly lower than the control group. The low birth weight children, postpartum hemorrhage, cesarean section for pregnant women of the study group in the 20 - 35 age were more than the control group. （2） The uric acid influenced the children perinatal asphyxia, premature birth, low birth weight children （ SE = 0. 359,0. 621,0. 486, P 〈 0. 05） ; The calcium influenced fetal distress, placental abruption （ SE = 0. 361,0. 473, P 〈 0. 05 ） ; The serum magnesium influenced the perinatal child mortality （ SE = 0. 732, P 〈 0. 05） ; The serum adiponectin levels influenced postpartum hemorrhage （ SE = 0. 348, P 〈 0. 05 ） ; The average diastolic blood pressure and mean systolic blood pressure influenced fetal distress, placenta early stripping, cesarean section （P 〈0. 05） ; The years of schooling and age influenced cesarean section （SE = 0. 441,0. 651, P 〈 0. 05 ）. Conclusion There are closely correlations between the prognosis of pregnancy hypertension and the age, years of education, blood pressure, serum calcium, serum magnesium, uric acid, serum adiponectin.