妊娠期高血压疾病患者视网膜病变期的危险因素分析

Risk factors for the occurrence of retinopathy stage in pregnancy-induced hypertension

目的观察分析妊娠期高血压疾病患者视网膜病变期发生的危险因素。方法回顾性临床研究。2018年1月至2019年12月于广州医科大学附属第三医院产科住院治疗的妊娠期高血压疾病患者260例纳入研究。患者均行眼底彩色照相检查,并收集其年龄、孕周、高血压病程、既往史、孕产次数、孕前体重指数(BMI)以及实验室血常规、谷丙转氨酶、天冬氨酸转氨酶、尿素氮、肌酐、尿酸、血清白蛋白浓度以及24 h尿蛋白浓度、尿蛋白量检查结果。260例患者中,眼底有无视网膜病变分别为60、200例,并据此分为视网膜病变组、无视网膜病变组。组间定量资料比较行独立样本t检验;等级资料比较行Mann-Whitney U非参数检验。2个组间比较有统计学差异变量为自变量,行二分类logistic回归分析。结果无视网膜病变组、视网膜病变组患者孕周(t=4.875)、孕前BMI(t=2.779)、最高收缩压(t=-4.799)、最低收缩压(t=-4.797)、最高舒张压(t=-4.226)、最低舒张压(t=-4.226)、血小板低值与高值及其波动(t=7.701、2.504、-6.083)、血清白蛋白浓度(t=13.255)、天冬氨酸转氨酶(t=-2.272)、尿素氮(t=-5.117)、肌酐(t=-2.735)、尿酸(t=-2.130)、24 h尿蛋白浓度(t=-7.801)和24 h尿蛋白量(t=-7.567)比较,差异均有统计学意义(P<0.05)。Logoistic回归分析结果显示,孕前BMI、最高收缩压、血小板低值、血清白蛋白与妊娠期高血压疾病视网膜病变发生相关(P<0.05)。结论高收缩压、低血小板、低血清白蛋白是妊娠期高血压疾病视网膜病变期发生的危险因素。

Objective To observe and analyze the risk factors of retinopathy in patients with hypertension in pregnancy.Methods A retrospective clinical study.From January 2018 to December 2019,260 patients with hypertension during pregnancy who were hospitalized in the Obstetrics Department of the Third Affiliated Hospital of Guangzhou Medical University were included in the study.All patients underwent fundus color photography examination.Their age,gestational age,course of hypertension,past history,number of pregnancy and childbirth,pre-pregnancy body mass index(BMI)and laboratory blood routine,alanine aminotransferase,aspartate aminotransferase,and urea Nitrogen,creatinine,uric acid,serum albumin concentration,and 24-hour urine protein concentration and urine protein content examination results were collected.Among the 260 patients,there were 60 and 200 patients with or without retinopathy in the fundus,respectively.Patients were divided into retinopathy group and no retinopathy group.The comparison of quantitative data between groups was performed by independent sample t test;the comparison of grade data was performed by Mann-Whitney U nonparametric test.The variable with statistical difference between the two groups was the independent variable,and the two-class logistic regression analysis was performed.Results Gestational week(t=4.875),pre-pregnancy BMI(t=2.779),highest systolic blood pressure(t=-4.799),lowest systolic blood pressure(t=-4.797),highest diastolic blood pressure(t=-4.226),minimum diastolic blood pressure(t=-4.226),low and high platelet values and their fluctuations(t=7.701,2.504,-6.083),serum albumin concentration(t=13.255),aspartic acid transaminase(t=-2.272),urea nitrogen(t=-5.117),creatinine(t=-2.735),uric acid(t=-2.130),24-hour urine protein concentration(t=-7.801)and 24-hour urine protein(t=-7.567)were compared.The difference was statistically significant(P<0.05).Logoistic regression analysis showed that pre-pregnancy BMI,maximum systolic blood pressure,low platelet value,and serum albumin were related to the occurrence of retinopathy of hypertension in pregnancy(P<0.05).Conclusion High systolic blood pressure,low platelets,and low serum albumin are the risk factors for the occurrence of retinopathy of hypertension in pregnancy.