发病前重度子痫前期患者临床预警因素分析

Analysis of clinical early warning informations of severe preeclampsia before onset

目的探讨发病前重度子痫前期患者产前检查的预警因素。方法采用观察性病例对照研究,研究组为2014年1月至2017年12月天津市围产保健转诊系统下天津市第五中心医院(北京大学滨海医院)分娩的77例单胎重度子痫前期孕妇,对照组取同期154例正常单胎孕妇。采用统计学方法分析重度子痫前期发病前的临床指标变化。结果高血压前期、体质量增长>0.85 kg/周、胎儿生长受限趋势、水肿及血浆白蛋白下降、血小板下降、产检依从性、总产检次数及三级医院产检次数与重度子痫前期发病相关(P<0.001)。多因素回归分析显示,高血压前期、体质量增长>0.85 kg/周、水肿、血小板下降、产检依从性差为重度子痫前期发病前的危险因素,三级医院产检次数增多为重度子痫前期的保护因素。结论高血压前期、体质量增长>0.85 kg/周、水肿、血小板下降、产检依从性差是重度子痫前期发病前临床预警因素。

Objective To explore the early warning informations of severepre-eclampsia before onset. Methods The study was an observational case-control study. The study group consisted of 77 single-pregnancy preeclampsia pregnant women and the control group took 154 normal cases who were delivered to Tianjin Fifth Central Hospital (Peking University binhai Hospital) from January 2014 to December 2017 in the perinatal care referral system in Tianjin. To analyze changes in clinical indicators before the onset of severe pre-eclampsia with statistical methods. ResultsPrehypertension, weight gain>0.85 kg/week, fetal growth restriction, edema and decline of plasma albumin, thrombocytopenia, poor compliance, perinatal examinations and examinations in tertiary hospitals were associated with severe pre-eclampsia (P<0.001). Multivariate regression analysis showed that the risk factors of severe preeclampsia were pre-hypertension, weight gain>0.85 kg/week, edema, thrombocytopeniaand poor compliance. The increase in the number of prenatal examinations in tertiary hospitals was a protective factor for severe preeclampsia. Conclusion Prehypertension, weight gain during pregnancy (>0.85 kg/week), edema, thrombocytopenia, and poor compliance were warning informations of severe pre-eclampsia, and the increased number of prenatal examinations in tertiary hospitals was a protective factor for severe pre-eclampsia.