影响早发型前期子痫患者不良生产结局的危险因素分析

Analysis on the risk factors of adverse pregnancy outcomes in patients with early-onset preeclampsia

目的探讨影响早发型前期子痫患者不良生产结局的危险因素。方法回顾性分析86例早发型前期子痫患者的临床资料,根据妊娠结局分为良好结局组70例与不良结局组16例,比较2组临床资料,并开展多因素分析,总结影响患者不良生产结局的危险因素。结果2组年龄与脑钠肽、尿酸、碱性磷酸酶水平差异无统计学意义(P>0.05),不良结局组尿蛋白、乳酸脱氢酶(LDH)、二聚体、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)水平高于良好结局组,白蛋白、血小板水平低于良好结局组,差异有统计学意义(P<0.05);以不良妊娠结局为因变量,以单因素分析中差异有统计学意义的7项因素为自变量进行非条件Logistic回归分析,经分析,LDH升高(OR=4.321)、AST升高(OR=5.478)、白蛋白降低(OR=3.521)是影响早发型前期子痫患者不良生产结局的独立因素。结论早发型前期子痫患者不良生产结局的影响因素主要为LDH、ALT与白蛋白水平,在为患者实施期待治疗过程中需加强生化指标检查,做好病情程度评估工作,必要时终止妊娠,以促使母婴结局改善。

Objective To explore the risk factors of adverse pregnancy outcomes in patients with early-onset preeclampsia.Methods The clinical data of 86 patients with early-onset preeclampsia were retrospectively analyzed.According to different pregnancy outcomes,they were divided into good outcome group(n=70)and adverse outcome group(n=16).The clinical data between the two groups were compared.The risk factors of adverse pregnancy outcomes were summarized by multivariate analysis.Results There was no significant difference in age,levels of brain natri-uretic peptide,blood uric acid and alkaline phosphatase between the two groups(P>0.05).The levels of urine protein,lactate dehydrogenase,dimer,aspartate aminotransferase and alanine aminotransferase in adverse outcome group were higher than those in good outcome group,while levels of albumin and platelets were lower than those in good outcome group(P<0.05).Non-conditional Logistic regression analysis showed that increased lactate dehydrogenase(OR=4.321),increased alanine aminotransferase(OR=5.478)and decreased albumin(OR=3.521)were independent influencing factors of adverse pregnancy outcomes in patients with early-onset preeclampsia.Conclusion The main influencing factors of adverse pregnancy outcomes in patients with early-onset preeclampsia include lactate dehydrogenase,alanine aminotr-ansferase and albumin.In the process of expectant treatment for patients,it is necessary to strengthen biochemical indexes detection and evaluate disease severity,and the termination of pregnancy should be implemented to promote the improve-ment of maternal and neonatal outcomes.