妊娠高血压综合征对远期血压水平的影响

目的 通过比较妊娠高血压综合征(妊高征)妇女和非妊高征妇女远期原发性高血压的发病情况及血压水平,探讨可能影响妊高征妇女远期血压水平的危险因素.方法 采用回顾性队列研究设计,收集1976年10月至2001年8月期间在开滦林西医院住院分娩的782例孕妇资料,根据是否患妊高征分为妊高征组与非妊高征组.随访5～34年,于2006年7月至2007年9月收集研究对象原发性高血压发病情况及相关资料进行分析.结果 (1)妊高征组和非妊高征组的原发性高血压累积发病率分别为29.87%和18.87%,妊高征组高于非妊高征组(P=0.022).(2)随访5～34(18.8±5.3)年后,随访时妊高征组和非妊高征组腰围分别为(86.06±10.15)cm和(83.07±8.19)em(P=0.015),体质指数(BMI)分别为(24.83±4.01)kg/m~2和(23.50±3.39)ke/m~2(P=0.006),血胆固醇分别为(5.11±0.88)mmol/L和(4.89±0.94)mmol/L(P=0.045),空腹血糖分别为(5.57±1.78)mmol/L和(5.20±1.38)mmol/L(P=0.010),差异均有统计学意义.(3)校正年龄、BMI等影响因素后,妊高征对收缩压水平有一定的影响(P=0.048),空腹血糖也与收缩压水平相关,而年龄、BMI、白细胞计数和尿酸对远期收缩压和舒张压均有影响.结论 妊高征妇女远期原发性高血压累积发病率高于非妊高征者;校正年龄、BMI等影响因素后,妊高征与远期收缩压水平相关.BMI、空腹血糖和胆固醇水平升高可能是妊高征患者远期血压水平升高的危险因素.

Perpetual impact of pregnancy-induced hypertension on blood pressure

Objective To explore the perpetual impact of pragnancy-induced hypertension on blood pressure. Methods This retrospective cohort study included 782 cases of pregnant women who hospitalized at Kailuan Linxi hospital between October 1976 and August 2001. Patients were divided to with pregnancy induced hypertension(PIH, n=77) group and non pregnancy induced hypertension (NPIH, n = 705) group. Patients were followuped for 5 to 34 years ( mean 18.8±5.3 years), the incidence of essential hypertension was obtained in July 2006 - September 2007. Results (1) The cumulative incidence of essential hypertension during follow up was significantly high in PIH group (29.87%) than that in NPIH group 18.87% (P =0.022). (2) At the final follow up, waist circumference; [(86.06±10.15) cm vs. (83.07±8.19) cm, P=0.015], BMI [(24.83±4.01) kg/m~2 vs. (23.50±3.39) kg/m~2, P = 0.006], TC[(5.11±0.88) mmol/L vs. (4.89±0.94) mmol/L, P = 0.045] and GLU [(5.57±1.78) mmol/L vs. (5.20±1.38)mmol/L, P = 0.010] were all significantly higher in PIH group than those in NPIH group. (3) After adjudgment of age and BMI, PIH was still significantly correlated with long-term systolic blood pressure levels (P = 0.048), fasting glucose level was also significantly associated with long-term systolic blood pressure. Age, BMI, white blood cell count and uric acid were also predictors for perpetual systolic and diastolic blood pressure levels. Conclusions Incidence of essential hypertension in women with PIH was higher than that in women without PIH. After edjudgment of covariates including age, BMI, and glucose, PIH was significantly associated with the level of systolic blood pressure. BMI, fasting glucose and cholesterol levels might contribute to the increase of systolic blood pressure in patients with PIH.