妊娠期高血压疾病患者尿蛋白成分与围生结局的关系

Analysis on the proteinuria component and perinatal outcomes in patients with gestational hypertensive disease

目的 探讨妊娠期高血压疾病患者尿蛋白成分对围生期结局的影响.方法 选取117例妊娠期高血压疾病患者和108例正常妊娠孕妇作为研究对象,根据尿蛋白成分分析结果将研究对象分为4组：生理性蛋白尿组、肾小管性蛋白尿组、肾小球性蛋白尿组和混合性蛋白尿组.分析尿蛋白成分与围生结局的关系.结果 不同蛋白尿组研究对象的妊娠期高血压疾病病情严重程度不同,差异均有统计学意义（均P＜0.01）.混合性蛋白尿组各种围生期并发症和母儿不良结局的发生率均较生理性蛋白尿组明显升高,差异均有统计学意义（均P＜0.01）.肾小球性蛋白尿患者有部分围生期并发症发生率较生理性蛋白尿患者升高,差异有统计学意义（P＜0.05）.结论 妊娠期高血压疾病患者的尿蛋白构成比正常妊娠孕妇复杂,尿蛋白成分与围生期并发症和母儿不良结局密切相关,出现肾小球性蛋白尿或混合性蛋白尿提示病情较重、母婴预后相对较差.

Objective To investigate the effect of proteinuria component in patients with gestational hypertensive disease on their perinatal outcomes. Methods 108 normal pregnant women and 117 gestational hypertensive disease women were selected for this study. Proteinuria component was analyzed from these pregnant women. According to the result, these women were divided into four groups, physiological proteinuria group, tubular proteinuria group, glomerular proteinuria group and mixed proteinuria group. The result of proteinuria component of these women and the relation between different types of proteinuria component and the perinatal outcome were analyzed. Results The severity of gestational hypertensive disease in different type of proteinuria component group is different （P 〈0.01）. There incidence of every severe implication in mixed proteinuria group is higher than in physiological proteinuria group （P 〈 0.01）. There incidence of some severe implications in glomerular proteinuria group higher than in physiological proteinuria group （P〈 0.05）. Conclusion More protein species were found in urinary sample of gestational hypertensive disease than that of normal pregnant women. Proteinuria component in patients with gestational hypertensive disease is closely related to their perinatal outcomes. Patients with glomerular proteinuria or mixed proteinuria may have more possibilities to have worse perinatal outcomes.