妊娠期蛋白尿病人的临床特征及围生结局分析

CLINICAL CHARACTERISTICS AND PERINATAL OUTCOME OF PATTIENTS WITH PROTEINURIA IN PREGNANCY

目的了解妊娠期蛋白尿病人的临床特征及围生结局,探讨应用尿蛋白定量预测围生结局的可行性。方法回顾性分析106例妊娠期蛋白尿病人的临床资料,总结分析其临床特征及围生结局。按24h尿蛋白定量分组,比较各组病人血清肌酐（sCr）水平、血压情况及围生结局的差异。结果中、重度蛋白尿病人血清sCr水平、高血压发生率及不良围生结局发生率均明显高于轻度蛋白尿组,重度蛋白尿组亦高于中度蛋白尿组,差异有显著性（F=4.453,χ^2=17.372、4.645,P〈0.05）。多因素分析结果显示,重度蛋白尿（OR=4.71,95%CI=0.92～22.54,P〈0.05）、慢性肾脏病病史（OR=3.58,95%CI=0.77～17.15,P〈0.05）及肾脏功能受损（OR=9.22,95%CI=2.65～89.18,P〈0.05）是不良围生结局的独立危险因素。结论妊娠期蛋白尿是不良围生结局的独立危险因素,尿蛋白定量可以作为预测围生结局的可靠指标之一。

Objective To investigate the clinical features and perinatal outcome in patients with proteinuria in pregnancy, and explore the feasibility of using urine protein quantitation to predict the perinatal outcome. Methods Clinical data of 106 pa- tients with proteinuria in pregnancy were retrospectively reviewed, the clinical features and perinatal outcome were analyzed. The patients were grouped by 24 h urine protein quantity, serum creatinine （sCr） levels and blood pressure. The perinatal outcome among each group were compared. Results The level of sCr, the incidence of hypertension and adverse perinatal outcome in pa- tients with moderate and severe proteinuria were higher than that in patients with mild proteinuria, the differences were statistically significant, and that in severe proteinuria group was higher than that in moderate proteinuria group, the difference was significant （F=4.453,X^2=17.372,4.645;P〈o.05）. Multivariate regression analysis showed that severe proteinuria, chronic kidney disease and impaired renal function were independent risk factors of adverse perinatal outcome. Conclusion The proteinuria in pregnan- cy is an independent risk factor of adverse perinatal outcome, and urine protein quantitation can be used as a reliable indicator for predicting the outcome.