肾病综合征型妊娠高血压疾病43例临床分析

Clinical analysis of 43 cases of nephrotic syndrome with pregnancy induced hypertension

目的探讨肾病综合征型妊娠期高血压疾病的临床特点和治疗。方法对中山市陈星海医院2000年6月-2006年6月收治的肾病综合征型妊娠期高血压疾病患者43例（按终止妊娠时孕周分为A组：孕周≤33w 12例,B组：33^1/7-36w17例,C组：≥36^1/7 w14例）及其新生儿46例进行回顾性分析,观察指标包括患者临床表现、治疗方法、并发症及预后、围产儿结局。结果肾病综合征型妊娠高血压疾病除具有妊娠期高血压疾病的特点外,主要表现为大量蛋白尿（〉3.5g/24h）、低蛋白血症（〈30g/L）、高度水肿及高脂血症,可出现严重并发症。治疗以综合治疗为主,并适时终止妊娠。围产儿结局较差,各组比较B组较A、C组好（P〈0.05）。结论肾病综合征型妊娠高血压疾病病情严重,围产儿预后不佳,应选择病例予综合治疗,并要严密监测母婴情况,适时终止妊娠可改善母婴预后。

Objective： To investigate the clinical characteristics and therapy of nephrotic syndrome with pregnancy induced hyper- tension （NSP）. Methods ： We retrospectively analyzed 43 NSP mothers and their 46 neonates who were cured in the zhongshan CHEN Xing - Hai hospital during June of 2000 to June of 2006. They were divided into three groups according to different time of pregnancy termination. Group A： ≤33 gestational weeks, Group B： 33^1/7 -36 gestational weeks, Group C： ≥36^1/7 gestational weeks. We studied the clinical manifestation, treatment methods of the mothers, complications and outcomes of both mothers and infants. Results： NSP have clinical features of pregnancy induced hypertension , in addition, the main clinical manifestation are large number proteinuria, （ 〉 3.58/24hour）, low proteinumia （ 〈 30g/L）, severe edema, high plasma fat. It may occur severe complication. Synthetic treatment should be exercised in treating patients with NSP. Pregnancy should be terminated at its optimal time. The out- comes of infants were better in B group than those in A, C group （ P 〈 0. 05 ）. Conclusion ： The pathogenetie condition of NSP is severe. The outcomes of infants are not good. Obstetricians should select eases for expectant treatment and close monitoring is very important for those mothers and infants. Pregnancy termination at its optimal time is helpful.