22例肾病综合征型妊娠高血压疾病的临床分析

22 cases of nephrotic syndrome with pregnancy induced hypertension clinical analysis

目的探讨NSP的临床特征、对母儿的影响、发病机制等。方法回顾性分析我院2005年1月～2010年12月住院的22例NSP产妇(NSP组)及除NSP以外的123例重度子痫前期产妇(对照组)的临床资料。结果 NSP组产妇的发病孕周、终止妊娠时的孕周均早于对照组,差异有统计学意义(P<0.05)。NSP组产妇重度水肿、腹腔积液、子痫、胎盘早剥发生率均高于对照组,差异有统计学意义(P<0.05)。NSP组产妇血清清蛋白低于对照组,而24h尿蛋白定量、血总胆固醇、尿素氮均高于对照组,差异有统计学意义(P<0.01)。NSP组胎儿生长受限,胎儿窘迫及早产儿的发生率均高于对照组,差异有统计学意义(P<0.05)。结论 NSP发病孕周较早,有些病例发病隐匿,应重视对其早期诊治,积极处理及加强母儿监护,适时终止妊娠,可减少其妊娠期并发症及围生儿发病率和病死率。

Objective This paper is to study various clinical features of NSP,including its effect on mother and fetus, and its pathogenesis. Methods By studying and comparing the information gathered from 22 pregnant women with NSP and 123 pregnant women with severe preeclampsia in our hospital from Jan. 2005 to Dec. 2010. Results The group with NSP starts disease and terminates pregnancy earlier than the contrast despite reasonable variations in statics （ P 〈 0. 05 ）. The rate of occurrence of NSP group＇s severe edema, ascites, eclampsia and placental abruption is higher than the contrasting group and despite reasonable variations in statistics （P 〈 0.05 ）. The serum proteins of NSP group is lower than the contrasting group, while the urine protein, cholesterol level in blood and urea nitrogen are higher than the contrast group despite statistical variations（P 〈 0.01 ）. The group with NSP suffer fetal growth restriction, and the occurring rate of fetal distress and premature infant is higher than the contrasting group and the variations are reasonable（P 〈 0.05 ）. Conclusion Since the NSP occurs at an early stage of pregnancy and some- times insidiously, it is important to treat it actively at an early period or to terminate pregnancy timely, so as to decrease the chance of pregnancy complication, perinatal disease or death.