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目的观察妊娠高血压综合征(妊高征)孕妇尿蛋白及血清蛋白的变化,分析对围生期结局的影响。方法选取2011年1月—2012年6月于湖南师范大学附属湘东医院住院的妊高征孕妇120例作为观察组,选取同期于本院分娩的中晚期正常孕妇72例作为对照组,比较两组的血压、血清蛋白、尿蛋白水平,并通过SAS-AGE电泳分析两组的尿蛋白成分,进行比较。结果观察组顺产率低于对照组(P<0.01),剖宫产率、围生儿死亡率、早产儿出生率、低体质量儿出生率均高于对照组(P<0.05)。观察组新生儿体质量为(2642.4±513.6)g,低于对照组的(3467.5±524.3)g,差异有统计学意义(P<0.05)。观察组孕妇的收缩压及舒张压水平均高于对照组,差异有统计学意义(P<0.05)。观察组24h尿蛋白量高于对照组,而总蛋白及清蛋白水平均低于对照组,差异有统计学意义(P<0.05)。观察组尿液中含有约11种蛋白成分,对照组尿液中含有约4种蛋白成分。结论妊高征孕妇尿蛋白水平的高低及成分构成与肾功能损害关系密切,对围生期结局有重要影响,通过分析尿蛋白成分,可在一定程度上评估预后。
Objective To observe the changes of urinary protein and serum protein in pregnant women with pregnancy induced hypertension (PIH) and analyze the effect on perinatal outcome. Methods From January 2011 to June 2012,120 cases of pregnant women with PIH admitted to Xiangdong Hospital Affiliated to Hunan Normal University were selected as the observation group and 72 normal pregnant women in the same period of delivery in our hospital were selected as the control group. The blood pressure, serum protein and urinary protein level of the two groups were compared by SAS-AGE electrophoresis. Results The birth rate of observation group was lower than that of control group (P <0.01). Cesarean section rate, perinatal mortality rate, birth rate of premature infant and birth weight of low birth weight children were all higher than those of control group (P <0.05). The neonatal weight in the observation group was (2642.4 ± 513.6) g, which was lower than that in the control group (3467.5 ± 524.3) g, the difference was statistically significant (P <0.05). The systolic blood pressure and diastolic blood pressure of pregnant women in the observation group were higher than those in the control group, the difference was statistically significant (P <0.05). The urinary protein in 24 hours in observation group was higher than that in control group, but the levels of total protein and albumin in observation group were lower than those in control group (P <0.05). The observation group contained about 11 kinds of protein in the urine, while the control group contained about 4 kinds of protein in the urine. Conclusion The level of urinary protein in pregnant women with PIH is closely related to the damage of renal function, and has an important influence on the outcome of perinatal pregnancy. The urinary protein composition can be used to evaluate the prognosis to a certain extent.