妊娠期高血压疾病合并心力衰竭的临床分析

Clinical Analysis of Gestational Hypertension Complicated with Heart Failure

目的探讨在妊娠期高血压疾病合并心力衰竭患者中低蛋白血症、平均动脉压、无创伤血流分析(CVT)、血细胞比容(HCT)、24 h尿蛋白定量的水平及临床意义。方法选取2004年6月至2010年12月在首都医科大学附属北京妇产医院治疗的妊娠期高血压疾病合并心力衰竭的病例27例,均符合妊娠期高血压疾病合并心力衰竭的诊断标准;另选取相同孕周发病的妊娠期高血压疾病病例27例作为对照,分析心力衰竭组和对照组的低蛋白血症、平均动脉压、CVT、HCT、24 h尿蛋白定量等各项指标的差异及临床意义。结果心力衰竭组的平均动脉压为(128.69±10.60)mm Hg,对照组为(113.52±11.98)mm Hg,P=0.000;心力衰竭组的白蛋白为(19.78±3.97)g/L,对照组为(22.78±5.75)g/L,P=0.030;心力衰竭组CVT的心脏指数为2.22±0.24,对照组为2.97±0.68,P=0.000;心力衰竭组CVT的外周阻力为1.50±0.25,对照组为1.33±0.33,P=0.043;心力衰竭组的HCT为0.36±0.06,对照组为0.33±0.05,P=0.043;24 h尿蛋白定量心力衰竭组为(5.63±3.23)g,对照组为(3.49±2.67)g,P=0.011。结论妊娠高血压疾病合并心力衰竭患者的白蛋白及CVT的心脏指数明显低于无心力衰竭发病者,24 h尿蛋白定量、平均动脉压、HCT及CVT的外周阻力明显高于对照组患者。

Objective To investigate the clinical significance of hypoproteinemia, mean arterial pres- sure, CVT, HCT, quantitative of ptoteinuria in 24 hour in gestational hypertension complicated with heart fail- ure. Methods 27 cases with gestational hypertension complicated with heart failure in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital University of Medical Sciences from June 2004 to December 2010 were enrolled in this study;another 27 cases with hypertensive disorder complicating pregnancy without heart failure were enrolled in this study as a control group. The clinical significance and difference of hy- poproteinemia, mean arterial pressure, CVT, HCT, quantitative of ptoteinuria in 24 hour of the two group were analyzed. Results The mean arterial pressure, heart failure group was （ 128.69 ±10.60 ） mm Hg, The con- trol was（ 113.52 ± 11.98 ） mm Hg（ P = 0. 000 ） ; the albumin, heart failure group was （ 19.78 ± 3.97 ） g/L, the control was（22.78±5.75 ）g/L（ P = 0. 030） ;the cardiac index in CVT ,heart failure group was 2.22 ± 0.24, the control was 2.97±0.68 （ P = 0. 000 ） ; The peripheral resistance in CVT, heart failure group was 1.50 ± 0.25, The control was 1.33 ±0.33 （ P = 0. 043 ） ; The HCT, heart failure group was 0.36 ± 0.06, the control was 0.33 ± 0.05 （ P = 0. 043 ） ; The quantitative of ptoteinuria in 24 hour, heart failure group was （5.63±3.23）g,the control was（3.49 ±2.67）g（P=0.011）. Conclusion The albumin and the cardiac index in CVT with gestational hypertension complicated with heart failure were lower than the controi, but the mean arterial pressure, HCT, quantitative of ptoteinuria in 24 hour and the peripheral resistance in CVT were higher than the control.