从如何看妊娠期高血压疾患分类和诊断标准变迁谈践行

How to understand the changes of the classification and diagnostic criteria of hypertensive disorders of pregnancy and think about the practice

伴随着对妊娠期高血压疾患(hypertensive disorders of pregnancy)的基础研究和临床研究进展,其诊断标准和分类是随之变迁最为活跃的部分,但在不同学术组织颁布的诊断标准和分类中,仍然有不尽一致之处。值得思考的问题包括:如何看待子痫前期的蛋白尿问题,如何看待子痫前期的轻度与重度问题,以及诊断重度子痫前期纳入标准不尽相同等问题。上述问题尤其反映出对子痫前期综合征的多因素和多通路发病的再认识问题。妊娠期高血压疾患的分类和诊断标准的变迁,虽然显示出对疾病认识的不断提升,但是不可忽视的是,患者群体并无实质迁移,重要的是如何将提升的认识,用来指导和提高对这一疾病群体的控制力。

With the advances in basic and clinical research on hypertensive disorders in pregnancy,diagnostic criteria and classification of hypertensive disorders in pregnancy are the most active parts of the changes,but different academic organizations still hold different opinions.The problems about hypertensive disorders in pregnancy are worth thinking about how to treat the protein uria,mild and severe preeclampsia,how to deal with the severe preeclampsia criteria inconsistency.These questions also reflect the re-recognition of the multifactors in pathogenesis as well as multi-path mechanism,especially in the syndrome of preeclampsia.Although the changes of classification and diagnostic standard of hypertensive disorders in pregnancy have shown a continuous improvement of the awareness on the disorders,we can not ignore that patient population did not migrate.It is important to use these awareness to guide and improve the control of the patients population.