子痫前期患者血流动力学异常与肾功能损害的相关性

The correlation of hemodynamic abnormalities and renal dysfunction in preeclampsia

目的分析子痫前期患者血流动力学异常与肾功能损害的相关性。方法选择子痫前期患者283例及妊娠高血压患者和正常孕妇各100例作为子痫前期组、妊高症组和正常对照组。检测肾功能指标,并采用无创监测系统检测子痫前期患者血流动力学参数。结果子痫前期组血清肌酐(Scr)、尿酸(UA)、尿素氮(BUN)显著高于妊高症组和对照组(P<0.05),肾小球滤过率(GFR)显著低于妊高症组和对照组,子痫前期组24h尿蛋白(24hpro)较妊高症组显著升高(P<0.05),重度子痫前期组Scr、UA、BUN、24hpro及肾功能损害率均显著高于轻度子痫前期组(P<0.05)。子痫前期肾功能损害组平均动脉压(MAP)、周围血管阻力(SVR)、周围血管阻力指数(SVRI)显著高于子痫前期无损害组(P<0.05),而心输出量(CO)、每搏输出量(SV)、心脏指数(CI)、每搏指数(SI)、速度指数(VI)显著低于无损害组(P<0.05)。CO、SV、SVR与子痫前期患者GFR存在线性回归关系(P<0.05)。结论子痫前期患者可出现靶器官损害,肾功能损害发生率与病情严重性有关,心功能下降和外周阻力增大是子痫前期患者肾功能损害的主要因素。

Objective To analyze the correlation of hemodynamic abnormalities and renal dysfunction in preeclampsia. Methods A total of 283 cases of preeclampsia and 100 cases of gestational hypertension patients and normal pregnant as the preeclampsia, pregnancy-induced hypertension group and normal control group. Detection of renal function, and used non-invasive monitoring system measured hemodynamic parameters in patients with preeclampsia. Results Preeclampsia Scr, UA, BUN, GFR, renal dysfunction were significantly higher pregnancy hypertension group and the control group （P 〈0.05）, 24hpro compared with pregnancy-induced hypertension were significantly higher （P 〈0.05）, severe preeclampsia group Scr, UA, BUN, 24hpro renal dysfunction were significantly higher than mild preeclampsia group （P 〈0.05）. Preeclampsia renal dysfunction group MAP, SVR, SVRI were significantly higher than those without damage group （P 〈0.05）. CO, SV, CI, SI, VI were significantly lower than without prejudice group（P 〈0.05）. CO, SV, SVR GFR in patients with preeclampsia there were linear regression （P 〈0,05）. Conclusion The patients with preeelampsia target organ damage could occur, the incidence of renal dysfunction and disease severity related to de- creased heart function and increased peripheral resistance in patients with preeclampsia are major factor in renal im- pairment.