重度子痫前期并发多器官功能障碍综合征发病危险因素分析

Analysis the risk factors of severe preeclampsia complicated with multiple organ dysfunction syndrome.

目的探讨重度子痫前期并发多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)的发病危险因素及临床特点。方法回顾性分析广州医学院第三附属医院2009年1月至2011年12月446例重度子痫前期病例资料,按照是否并发MODS,分为重度子痫前期并发MODS组(61例)与单纯重度子痫前期组(385例)。分析危险因素、实验室检查结果、围产期信息和妊娠结局。结果 (1)重度子痫前期的发生率为2.77%(446/16102),重度子痫前期并发MODS的发生率13.68%(61/446)。(2)瘢痕子宫(OR=2.315)、不定期产检(OR=2.595)、无产检(OR=4.000)、合并慢性高血压(OR=3.286)、合并肾脏疾病(OR=3.036)是发生重度子痫前期并发MODS的危险因素;高中或以上文化程度是保护因素。(3)两组输血或血浆制品、ICU入住率差异有统计学意义(P<0.05)。结论瘢痕子宫、不定期产检、无产检、合并慢性高血压、合并肾脏疾病是发生重度子痫前期并发MODS的危险因素。

Objective To investigate the risk factors and clinical characteristics of severe preeclampsia complicated with multiple organ dysfunction syndrome （MODS）. Methods A retrospective study was performed in 446 cases of severe preeclampsia between January 2009 and December 2011 in the Third Affiliated Hospital of Guangzhou Medical Universi- ty. The women were divided into MODS group （61 cases） and pure severe preeclampsia group （385 cases）. The risk factors, laboratory test results and pregnancy outcome of pure severe preeclampsia and severe preeclampsia complicated MODS was evaluated. Results （ 1 ） Severe preeclampsia gave an incidence of 446 in 16102 deliveries （ 2. 77% ）. MODS occurred in 61 of 446 patients with severe preeclampsia （ 13.68% ）. （2） The risk factors of severe preeclampsia complicated with MODS were scarred uterus （OR = 2. 315 ）, non-periodic prenatal visit （OR = 2. 595 ）, none prenatal visit （ OR = 4. 000 ）, complicated with chronic hypertension disease （ OR = 3. 286 ）, complicated with kidney disease （ OR = 3. 036）. The protective factors were higher education, senior high school（ OR = 0. 123 ）, college or above （ OR = 0. 074）. （3） Transfusion and ICU occupancy were statistically significant （ all P 〈 0. 05）. Conclusion The risk factors of severe preeclampsia complicated with MODS were scarred uterus, non-periodic prenatal visit, none prenatal visit, complicated with chronic hypertension disease, complicated with kidney disease.