慢性高血压合并妊娠发生子痫前期的危险因素分析

Analysis of the Risk Factors of Preeclampsia in Chronic Hypertension with Pregnancy

目的：探讨慢性高血压合并妊娠发生子痫前期的危险因素,为筛查慢性高血压孕妇合并子痫前期提供参考依据。方法：选取2009年3月~2013年7月我院收治的慢性高血压妊娠患者116例,根据是否合并子痫前期分为慢性高血压合并妊娠组（NHDP组）和慢性高血压合并子痫前期组（HDP组）,比较两组患者不同孕期的血压、尿蛋白水平以及血液生化检测指标间的差异。结果：两组间年龄、孕次、孕前尿蛋白水平、孕早期及孕中期的平均动脉压、尿蛋白水平间差异均无统计学意义（P〉0.05）。HDP组孕前体质指数、孕晚期的平均动脉压、尿蛋白水平、Hb、UA、LDH、FDP均较NHPD组显著升高（P〈0.05）,两组间Plt水平差异无统计学意义（P〉0.05）。logistic回归分析发现Hb、UA及FDP是慢性高血压妊娠患者并发子痫前期的危险因素。结论：凝血状况、血清尿酸水平及肾功能变化是慢性高血压合并妊娠者发生子痫前期的危险因素。

Objective： To investigate the risk factors of preeclampsia in chronic hypertension with pregnancy and provide the references for screening pregnant women with chronic hypertension complicated with preeclampsia. Methods： 116 cases with chronic hypertension in pregnancy who were treated in our hospital from March 2009 to July 2013 were selected and divided into the chronic hypertension in pregnancy group（NHDP group） and the chronic hypertension complicated with preclampsia group（HDP group）according to the complicated with preeclampsia. Then the clinical data, blood pressure and urine protein during different periods of pregnancy of the groups were observed and compared. Results： There was no significant difference between HDP group and NHDP group in age, times of pregnancy and pre pregnancy urine protein content（P〉0.05）. The prepregnancy body mass index, average artery pressure during the third trimester, urinary protein level, Hb, UA, LDH, FDP of HDP group were significantly higher than those of the NHPD group（P〈0.05）. No significant difference was found in the Plt level between two groups（P〉0.05）; The logistic regression analysis showed that Hb, UA and FDP were the risk factors of reeclampsia in chronic hypertension with pregnancy. Conclusions： The coagulation status, serum uric acid level and change of renal function were risk factors of preeclampsia in chronic hypertension with pregnancy.