子痫前期孕妇血压昼夜节律异常与围生儿结局的关系分析

Analysis of the relationship between blood pressure circadian rhythm abnormalities in preeclampsia pregnant women and perinatal infant outcomes

目的探讨子痫前期患者血压昼夜节律异常对围生儿结局的影响。方法选取住院分娩诊断子痫前期患者共217例,其中轻度子痫前期99例,重度子痫前期118例;另选取同期住院分娩的孕妇57例为对照组。动态血压监测所有患者白天与夜间的血压,并根据血压昼夜节律将患者分为杓型、非杓型及反杓型。结果子痫前期患者发生非杓型和反杓型昼夜节律的概率明显高于对照组(P均<0.001);反杓型出现各种围生儿不良结局比非杓型及杓型患者都高(P<0.05)。结论血压昼夜节律异常对围生儿结局有不利影响,尤其更应关注反杓型患者,加强夜间降压力度,掌握时机适时终止妊娠有利于母婴安全。

Objective To discuss the effect of blood pressure circadian rhythm abnormalities in preeclampsia patients on perinatal infant outcomes. Methods A total of 217 preeclampsia patients in hospital were selected in the research,including 99 cases with mild preeclampsia and 118 cases with severe preeclampsia. Other 57 pregnant women of concurrent hospital delivery were selected as the control group. The ambulatory blood pressure of all patients during day and at night were monitored.All patients were classified by three groups, dipper type, non-dipper type and anti-dipper type, according to the circadian rhythm of blood pressure. Results The incidence of non-dipper type and anti-dipper type in group of preeclampsia patients was significantly higher than that of the control group (P &lt;0.001).The incidence of various adverse perinatal infant outcomes were higher in patients with anti-dippers type blood pressure. The incidence of adverse perinatal infant outcomes in patients with anti-dipper type were markedly higher compared with patients from dipper and non-dipper type(both P&lt;0.05)Conclusion Circadian rhythm abnormalities adversely affected the outcome of perinatal infants. Therefore, more attention should be focused on anti-dipper type patients. It will be helpful for maternal and infants′ safety by strengthening efforts to reduce nocturnal blood pressure and grasping the timely opportunity to terminate the pregnancy.