低蛋白血症和蛋白尿对妊高征围产期结局的影响

Influence of pregnancy-induced hypertension rsyndrome on perinantal outcome by hypoproteinmia and proteinuria

目的探讨低蛋白血症、尿蛋白的丢失对妊娠高血压综合征(妊高征)患者围产期结局的影响。方法对妊高征患者110例和60例正常妊娠对照组的血清总蛋白、白蛋白和24h尿蛋白定量,进行对照分析及相关性分析。结果①妊高征组的剖宫产率、围产儿死亡率明显高于对照组,早产儿出生明显增多,而新生儿出生体重低于正常对照组;②妊高征组血清总蛋白和白蛋白含量明显低于正常对照组,24h尿蛋白定量明显高于正常对照组;③校正孕龄后的相关性分析表明,白蛋白与新生儿体重有明显正相关性,随着24h尿蛋白量的增加,新生儿体重渐降低,两者呈明显负相关性。结论妊高征患者低蛋白血症及尿蛋白的丢失与其病情及围产儿预后密切相关,可以作为妊高征的临床监测指标,指导正确诊断、治疗和处理,适时终止妊娠,达到降低孕产妇及围生儿的死亡率,改善母婴预后的目的。

Objective To investigate the influence of pregnancy-induced hypertension （PIH） on perinantal outcome by hypoproteinmia and the loss of urine protein. Methods Blood serum total protein, blood serum albumin and 24 - hour urine protein excretion were measured in 110 patients with PIH and 60 women with normal pregnancy from January 2004 to May 2005. Results ① Patients with PIH had more cesarean delivery and higher neonatal mortality than normal pregnancy. Patients with PIH had more premature birth than normal pregnancy while birth weights were significantly lower than the latters;② The levels of blood serum total protein and albumin in patients with PIH were significantly lower than in normal pregnancy. The levels of 24-hour urine proteinuria excretion were significantly lower than in normal pregnancy;③ Neonatal weights had a positive correlation with levels of blood serum albumin but had a negative correlation with levels of 24-hour urinary protein excretion. Conclusion Hypoproteinmia and the loss of urine protein are associated with PIH and neonatal outcomes. They can be used as markers for clinical monitoring. They are important for diagnosis, treatment of PIH and for reducing the death of perinatal infant in order to improving the perinatal outcome.