妊高征患者蛋白尿及肾功能与围产期结局的关系

Correlation Between Proteinuria,Renal Function and Perinatal Outcomes in Pregnancy-Induced Hypertension

目的 :探讨妊娠高血压综合征 (妊高征 )患者蛋白尿、肾功能与围产期结局的关系。方法 :测定 15 0例妊高征患者和 4 0例正常孕产妇的 2 4h尿蛋白定量、血清尿素氮 (BUN)、尿酸 (UA)、肌酐 (Cr)、钙 (Ca2 + )和血压水平。结果 :(1)妊高征患者分娩时间明显提前 ,早产儿发生率和围产儿病死率均明显高于正常妊娠组 (P <0 .0 1) ,新生儿体重则明显低于正常妊娠对照组 (P <0 .0 0 1)。 (2 )妊高征组血压、BUN、UA、Cr、2 4h尿蛋白量均明显高于正常妊娠组(P <0 .0 0 1) ,而白蛋白 (Alb)、Ca2 + 均明显低于正常妊娠组 (P <0 .0 0 1)。 (3)随着收缩压的升高和 2 4h尿蛋白量的增加 ,新生儿体重逐渐降低 (P <0 .0 0 1)。 (4 )随着 2 4h尿蛋白量的增加 ,分娩周数逐渐缩短 (P <0 .0 5 ) ,血压、BUN、UA、Cr均逐渐升高 (P <0 .0 0 1) ,而Alb和Ca2 + 则逐渐降低 (P <0 .0 0 1)。(5 )相关分析表明新生儿体重与分娩周数、Ca2 + 呈明显正相关 ,而与 2 4h尿蛋白量、SBp、BUN呈明显负相关 ;2 4h尿蛋白量与分娩周数、新生儿体重、DBp、BUN、UA、Alb、Ca2 + 等 7项指标呈明显相关性 ;BUN与分娩周数、新生儿体重、2 4h尿蛋白量、UA、Cr、Ca2 + 等 6项指标呈明显相关性 ;UA与分娩周数、2 4h尿蛋白量、BUN、Cr、Alb、Ca2 + 等 6项?

Objective:To investigate the correlation between proteinuria, renal function and perinatal outcomes in pregnancy-induced hypertension (PIH).Methods:24-hour urinary proteinuria excretion(24h-UPE), blood urea nitrogen (BUN),uric acid (UA),creatinine (Cr),calcium(Ca 2+ ) and blood pressure levels were measured in 150 patients with PIH and 40 women with normal pregnancy.Results:Patients with PIH delivered significantly earlier than normal pregnancy. Patients with PIH had more premature birth and higher neonatal mortality than normal pregnancy(P<0.01).Their infants had significantly lower birth weights than normal pregnancy(P<0.001).The levels of blood pressures,BUN,UA,Cr and 24h-UPE in patients with PIH were significantly higher than those in normal 24h-UPE (P<0.001),and levels of albumin (Alb) and Ca 2+ were significantly lower than that in normal pregnancy(P<0.001).Neonatal weight decreased significantly as the systolic blood pressure (SBp) and 24h-UPE increased(P<0.001).With the increasing of 24h-UPE,blood pressures,BUN,UA and Cr increased significantly(P<0.001), but gestational age at delivery,Alb and Ca 2+ decreased significantly (P<0.05,P<0.001).Neonatal weights had a positive correlation with gestational age at delivery and Ca 2+ levels, but had a negative correlation with levels of 24h-UPE,SBp and BUN.24-hour urine protein was associated with gestational age at delivery,neonatal weights,levels of diastolic blood pressure(DBp),BUN,UA,Alb and Ca 2+ levels.The BUN levels were associated with gestational age at delivery,neonatal weights,levels of 24-hour urine protein,UA,Cr and Ca 2+ .The UA levels were associated with gestational age at delivery,levels of 24-hour urine protein,BUN,Cr and Ca 2+ .The Ca 2+ levels were associated with gestational age at delivery, neonatal weights,levels of 24-hour urine protein,SBp, DBp,BUN,UA,Cr and Alb.Conclusion:The levels of blood pressure,24h-UPE, BUN,UA and Ca 2+ was associated with PIH and neonatal outcomes.They can be used as markers for clinical monitoring and are important for diagnosis and treatment of PIH and for improving the perinatal outcome.