重度子痫前期患者产后高血压危险因素分析

Risk Factors of Postpartum Hypertension in Patients With Severe Preeclampsia

目的探讨重度子痫前期(preeclampsia,PE)患者产后高血压的相关危险因素。方法选择2020年1月—2023年1月贵州中医药大学第一附属医院收治的重度PE患者200例,检测血压,根据血压情况分为高血压组(n=72)和非高血压组(n=128)。比较两组的年龄、孕次、产次、术中出血量、术后2 h出血量、24 h尿蛋白、血糖、血脂及肝肾功能等指标,采用多因素Logistic回归分析重度PE产后高血压的危险因素。结果两组产次、孕次、产前白细胞、红细胞、血小板、尿素氮、谷丙转氨酶、总胆红素、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)指标比较,差异无统计学意义(P>0.05)。高血压组年龄、术中出血量、术后24 h出血量、血红蛋白、肌酐、尿酸、24 h尿蛋白定量指标、总胆固醇、三酰甘油与非高血压组相比更高,血白蛋白和高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)与非高血压组相比更低(P<0.05)。多因素Logistic回归分析显示,血红蛋白、三酰甘油、24 h尿蛋白定量升高、血白蛋白降低、产前收缩压、产前舒张压、产后收缩压上升是重度PE产后高血压的危险因素(P<0.05)。结论高血红蛋白、三酰甘油、24 h尿蛋白定量、产前血压升高和产后舒张压升高、血白蛋白下降是重度PE产后发生高血压的危险因素。

Objective To explore the risk factors of postpartum hypertension in patients with severe preeclampsia(PE).Methods A total of 200 patients with severe PE admitted to the First Affiliated Hospital of Guizhou University of Chinese Medicine from January 2020 to January 2023 were selected to detect blood pressure,and were divided into hypertension group(n=72)and non-hypertension group(n=128)according to blood pressure.Age,gestational time,delivery time,intraoperative blood loss,2 h postoperative blood loss,24 h urinary protein,blood glucose,blood lipid and liver and kidney function were compared between the two groups.Multiple Logistic regression was used to analyze the risk factors of postpartum hypertension with severe PE.Results There was no significant difference in parity,prenatal white blood cells,red blood cells,platelets,urea nitrogen,alanine aminotransferase,total bilirubin and low-density lipoprotein cholesterol(LDL-C)between the two groups(P>0.05).The age,intraoperative blood loss,postoperative 24 h blood loss,hemoglobin,creatinine,uric acid,quantitative indexes of 24 h urinary protein,total cholesterol and triglyceride in hypertensive group were higher than those in non-hypertensive group,and serum albumin and (high density lipoprotein cholesterol,HDL-C)was lower than non-hypertensive group(P<0.05).Multivariate Logistic regression analysis showed that increased hemoglobin,triglyceride,24 h urinary protein quantity,decreased blood albumin,prenatal systolic blood pressure,prenatal diastolic blood pressure and postpartum systolic blood pressure were risk factors for severe PE postpartum hypertension(P<0.05).Conclusion High hemoglobin,triglyceride,24h urinary protein quantification,prenatal elevated blood pressure and postpartum diastolic blood pressure,and decreased blood albumin are risk factors for hypertension after severe PE.