眼底观察在妊娠期高血压综合征诊疗中的临床意义

Fundus observation in treatment of pregnancy induced hypertension syndrome

目的观察妊娠期高血压综合征患者眼底病变情况,为临床诊疗提供依据。方法分析1 026例妊娠期高血压综合征患者的临床资料,观察不同分期、血压、红细胞比容、蛋白尿水平的眼底改变。结果患者中眼底正常296例(28.85%);眼底改变730例(71.15%),其中Ⅰ期改变390例(38.01%),Ⅱ期改变219例(21.35%),Ⅲ期121例(11.79%);血压越高患者眼底改变的分期越大,患者血压>160/110 mmHg时,患者眼底改变率达100.00%;蛋白尿水平越高,患者眼底病变程度越明显,当蛋白尿水平>+++时,患者眼底视网膜病变Ⅲ期发生率达40.67%;红细胞比容>35%时,眼底病变改变率为84.82%,其中Ⅱ期改变率为32.55%。结论眼底观察有助于妊娠期高血压综合征患者病情的诊疗,对防止患者产后视网膜疾病及子痫等病变具有重要的意义。

Objective To analyze the retinal lesions in patients with pregnancy-induced hypertension syndrome,provide the basis for clinical diagnosis and treatment.Methods The clinical data of 1 026 cases with pregnancy-induced hypertension syndrome diagnosed and treated in the obstetric department of the hospital were analyzed to observe the different stages,blood pressure,hematocrit value,proteinuria levels and their relationship with retinal changes.Results Out of the patients,normal fundus included 296 cases（28.85%）;fundus changes involved 730cases（71.15%）,of which stage Ⅰ change was 390 cases（38.01%）,stage Ⅱ change 219 cases（21.35%）,stage Ⅲ change 121 cases（11.79%）;the higher the blood pressure in patients,the greater retinal changes in staging,patients with high pressure was higher than 160 mmHg,while low pressure was higher than 110 mmHg,retinal changes in patients with stage Ⅱ,Ⅲ change rate were up to 100.00%.The urinary protein levels were higher,the retinal lesions were more obvious.When proteinuria levels were 〉＋ ＋ ＋,the retinal lesions in patients with stage Ⅲ occurrence was up to 40.67%.When hematocrit value 〉35%,retinopathy change was 84.82%,stage Ⅱchange was 32.55%.Conclusion Fundus observation helps the diagnosis and treatment of pregnancy-induced hypertension syndrome,it is of great significance to prevent retinal disease and postpartum eclampsia and other diseases in the patients.