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目的探讨心理社会应激与妊娠期高血压疾病发生、发展的关系。方法对2 0 0 3年3月至2 0 0 4年1月西安交通大学第一医院的4 0例妊娠期高血压疾病孕妇(观察组)及4 0例正常孕妇(对照组)采用A型行为、生活事件和状态焦虑 特质焦虑问卷进行调查分析并测定2 4h尿儿茶酚胺类应激性递质水平。结果(1)观察组A型行为2 7例,占6 7 5 % ,对照组A型行为13例,占32 5 % ,两组比较差异有非常显著性意义(P <0 0 1) ,A型行为相对危险度为4 31,其95 %可信区间为1 73～10 76 ,P <0 0 1。(2 )观察组生活事件及状态焦虑特质焦虑评分与对照组比较差异有显著性意义(P <0 0 5 )。(3)观察组2 4h尿肾上腺素及去甲肾上腺素水平显著高于对照组(P <0 0 1)。结论A型行为、应激性生活事件及焦虑情绪等心理社会应激与妊娠期高血压疾病的发生密切相关。
Objective To explore the relationship between psychosocial stress and the occurrence and development of hypertensive disorder complicating pregnancy. Methods From March 2003 to January 2004, 40 pregnant women with gestational hypertension (observation group) and 40 normal pregnant women (control group) from the First Hospital of Xi’an Jiaotong University underwent type A Behavioral, life events and state anxiety trait anxiety questionnaire were investigated and analyzed 24 h urine catecholamine stress transmitter levels. Results (1) A group of 27 cases (67.5%) in the observation group and 13 cases of the A group (32.5%) in the control group, the difference between the two groups was significant (P <0.01), A The relative risk of type behavior was 4 31 with a 95% confidence interval of 1 73 to 10 76 (P <0.01). (2) There was significant difference between the observation group in life events and state anxiety trait anxiety score and the control group (P <0.05). (3) The levels of urinary epinephrine and norepinephrine in the observation group at 24 hours were significantly higher than those in the control group (P <0.01). Conclusions Psychosocial stress, such as type A behavior, stressful life events and anxiety, is closely related to the occurrence of hypertensive disorder complicating pregnancy.