子痫前期严重并发症的危险因素分析

Analysis of risk factors of preeclampsia with serious complications

目的 探讨子痫前期患者发生严重并发症的危险因素。方法回顾性分析805例子痫前期患者及其围产儿临床资料，将发生严重并发症的327例患者作为研究组，478例未发生严重并发症患者作为对照组。结果（1）子痫前期严重并发症发生率为40．6％（327／805例），327例患者的严重并发症包括138例死胎（42．2％）、71例HELLP综合征（21．7％）、65例胎盘早剥（19．9％）、39例心功能衰竭（11．9％）、39例产后出血（11．9％）、36例肺水肿（11．0％）等。（2）两组患者临床表现进行的比较，发病孕周、收缩压、舒张压、血肌酐、丙氨酸转氨酶、血清白蛋白和期待治疗时间，差异具有统计学意义（P〈0．05）。（3）多因素logistic回归分析提示子痫前期严重并发症独立危险因素为：发病孕周早（OR=0．783，95％CI：0．745～0．823）、高血肌酐（OR=1．005，95％C1：1．001～1．008）、低白蛋白（OR=0．961，95％CI：0．929～0．994）。结论子痫前期严重并发症发生危险因素为发病孕周早、。肾功能损害、低蛋白血症。

Objective To explore the risk factors of preeclampsia with serious complications. Methods Clinical data of 805 preeclampsia patients and the perinatal infants were retrospective analyzed. Three hundred and twenty-seven cases with serious complications were in the research group, 478 cases without serious complications were in the control group. Results （ 1） The incidence of preeclampsia patients with serious complications was 40. 6% （327/805 cases）. The serious complications of 327 cases were including fetal death （ 138 cases, 42. 2% ） , HELLP syndrome （71 cases, 21.7% ） , placental abruption （65 cases, 19. 9% ） , cardiac failure （ 39 cases, 11.9% ） , postpartum hemorrhage （ 39 cases, 11.9% ）, pneumonedema（36 cases, 11.0% ） and so on. （2） The clinical manifestation of the two groups, including onset gestational age, systolic pressure, diastolic pressure, creatinine, alanine aminotransferase, albumin and expecting treatment time had statistical significance, P 〈 0. 05. （ 3 ） In multivariate logistic regression analysis, the risk factors of preeclampsia serious complications were the gestational age of early onset （ OR = 0. 783, 95% CI： 0. 745 - 0. 823 ）, high serum creatinine （ OR = 1. 005, 95% CI： 1. 001 - 1. 008）, hypoproteinemia （ OR =0. 961,95% CI： 0. 929 -0. 994）. Conclusion The risk factors of preeclampsia with serious complications were the gestational age of early onse, kidney function damage and hypoproteinemia.