多血流动力学参数在妊娠高血压综合征预测中的应用

Application of multiple hemodynamic parameters in the prediction of gestational hypertension syndrome

目的:监测血流动力学参数对妊娠高血压综合征(妊高征)的前瞻性预测效果评价及对妊高征疑似患者干预效果的评价。方法:应用DAS-1000动脉硬化检测仪,对488例孕妇进行妊娠高血压综合征预防性监测,从中筛选出妊高征疑似患者114例,并随机分为干预组和观察组。其中干预组86例,给予药物和特殊护理干预;观察组为28例,只定期产前检查,做一般护理干预。结果:预测阳性风险52例,临床确诊妊高征35例,确诊率65.4%;中等风险62例,临床确诊妊高征16例,确诊率25.8%,预测中等风险与阳性风险的妊高征发生率差异具有统计学意义(P<0.05);在114例随访病例中,最终确诊为妊高征与非妊高征患者的外周阻力(SVR)差异无统计学意义(P>0.05),而平均动脉压(MAP)与脉搏波传导速度(PWV)差异具有统计学意义(P<0.05)。干预组中临床确诊妊高征37例,确诊率43.0%;观察组临床确诊妊高征13例,确诊率46.4%,干预组妊高征的发生率与观察组中妊高征的发生率差异无统计学意义(P>0.05),临床干预效果不明显。所有妊高征疑似患者中,最终临床确诊妊高征的患者共50例,临床确诊率达43.86%。结论:动脉硬化检测仪所测平均动脉压、外周阻力、脉搏波传导速度联合预测妊高征具有较大的临床价值,前瞻性的检测这些参数可有助于预测妊娠期高血压综合征的发生与发展。

Objective Evaluation of prospective predictive effect of monitoring hemodynamic parameters on pregnancy induced hypertension syndrome and intervention effect of monitoring hemodynamic parameters on suspected patients with pregnancy induced hypertension.Method Using DAS-1000 arteriosclerosis detector,488 pregnant women who came to our hospital for ultrasonography were monitored for pregnancy-induced hypertension,114 suspected patients with PiH were screened out,and were randomly divided into intervention group and observation group.Among them,86 patients in the intervention group were given medicine and special care intervention.The observation group consisted of 28 patients with regular prenatal examination and general nursing intervention.Results Fifty-two patients were diagnosed with pregnancy-induced hypertension,and 35 cases were diagnosed clinically,with a diagnosis rate of 65.4%.There were 62 patients with medium risk and 16 patients with clinical diagnosis of pregnancy-induced hypertension,with a diagnosis rate of 25.8%.The difference in the incidence of expectant hypertension between the patients with medium and positive risk was statistically significant(P<0.05).In 114 follow-up cases,there was no statistically significant difference in peripheral resistance(SVR)between patients diagnosed with or without sas(P<0.05),and the difference between MAP and PWV was statistically significant(P<0.05).The diagnosis rate of pregnancy-induced hypertension was 43.0%in 37 cases.There were 13 patients with clinical diagnosis of eclampsia in the observation group,with a diagnosis rate of 46.4%.There was no statistical difference in the incidence of eclampsia in the intervention group and the observation group(P>0.05),and the clinical intervention effect was not obvious.Among all the patients with pregnancy-induced hypertension,there were 50 patients with pregnancy-induced hypertension diagnosed clinically,with a clinical diagnosis rate of 43.86%.Conclusion It is of great clinical value to predict pregnancy-induced hypertension with the detection of mean arterial pressure,peripheral resistance and pulse wave conduction velocity.