子前期的视网膜病变及其相关因素分析

Retinopathy and Its Associated Factors in Patients with Preeclampsia

目的:回顾性分析足月分娩的子前期及妊娠期高血压患者的视网膜病变和各种临床实验室表现及胎儿体质量的关系。方法:观察60例子前期及65例妊娠期高血压女性的视网膜病变,检测收缩压、舒张压、胎儿体质量及血尿酸、丙氨酸转氨酶、天冬氨酸转氨酶、白蛋白、肌酐、尿素等各种生化指标并进行统计学分析。结果:2组间视网膜病变、胎儿出生体质量和孕妇血清尿酸水平差异有统计学意义(P<0.05),而其他指标比较差异无统计学意义(P>0.05)。子前期组视网膜病变的严重程度与胎儿体质量呈负相关(rs=-0.369,P<0.05),与血清尿酸水平呈正相关(rs=0.349,P<0.05),子前期组的其他变量收缩压、舒张压、丙氨酸转氨酶、天冬氨酸转氨酶、白蛋白、尿素及肌酐与视网膜病变无明显相关性。在妊娠期高血压组,所分析的参数与视网膜病变无显著相关(P>0.05)。结论:子前期视网膜病变的严重程度与胎盘功能不全和宫内生长受限的程度直接相关,与收缩压无明显相关性。

Objective： To study retrospectively the relationship between the retinopathy, various clinical and laboratory manifestations and fetal birth weight in patients with preeclampsia and gestational hypertension（GH）. Methods： Medical records,including retinopathy, systolic blood pressure（BP）, diastolic blood pressure, fetal weight, blood uric acid, alanine transarninase, aspartate aminotransferase, albumin, creatinine and urea, were reviewed and analyzed in 60 patients with preeclampsia and 65 patients with GH. Results： There were significant differences in retinopathy, fetal birth weight and serum level of uric acid in two groups （P 0.05）, but no significant differences was found in other parameters（P 0.05）. The severity of retinopathy was negatively related to the fetal birth weight（rs = -0.369,P 0.05） and positively related to the serum uric acid level in the preeclampsia group（rs = 0.349,P 0.05）. There were no significant association between other variables and retinopathy in the preeclampsia group, including systolic BP and diastolic BP, alanine transarninase, aspartate aminotransferase, albumin, urea and creatinine. In the GH group, none of the parameters were significantly associated with the ocular changes（P 0.05）. Conclusion： The severity of retinopathy is directly related to the level of placental insufficiency and intrauterine growth retardation in preeclampsia. The severity of retinopathy might be independent of systemic BP.