动态血压联合24小时尿蛋白定量监测在子痫前期及其妊娠结局中的应用价值

doi:10.3969/j.issn.1006-6233.2022.08.026

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摘要 目的: 探讨动态血压联合24小时尿蛋白定量监测对子痫前期及其妊娠结局的应用价值。方法: 选择2019年1月至2020年12月我院产科住院分娩,并且最终确诊为子痫前期孕妇的病例78例为研究对象,根据母婴是否出现不良妊娠结局对纳入的患者分为有不良妊娠结局的观察组32例,以及无不良妊娠结局的对照组46例。分别进行24小时动态血压监测和尿蛋白定量分析。结果: 观察组dSBP、dDBP、nSBP、24hDBP均高于对照组(P<0.05);观察组患儿最终出生体重(FBW)明显低于对照组(t=6.261,P<0.001);观察组24小时尿蛋白定量明显高于对照组(t=2.986,P<0.001);观察组和对照组所有患者夜间SBP血压负荷值及DBP血压负荷值明显高于白天(P<0.001)。结论: 子痫前期患者异常昼夜节律发生率较高,以非杓型昼夜节律、夜间血压升高为其特点,且动态血压和蛋白尿监测可提示患者不良妊娠结局,临床可通过监测上述指标,提前干预治疗,改善不良妊娠结局。

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关键词 ：子痫前期, 动态血压监测, 24小时尿蛋白定量, 妊娠结局

Abstract：Objective: To investigate the value of ambulatory blood pressure combined with quantitative 24-hour urine protein monitoring in pre-eclampsia and its pregnancy outcome. Methods: From January 2019 to December 2020, 78 cases of pregnant women with pre-eclampsia were selected for the study. The patients were divided into 32 cases in the observation group with adverse pregnancy outcomes and 46 cases in the control group without adverse pregnancy outcomes according to whether the mothers and infants had adverse pregnancy outcomes. 24-hour ambulatory blood pressure monitoring and quantitative urine protein analysis were performed respectively. Results: The dSBP, dDBP, nSBP and 24hDBP were all higher in the observation group than in the control group (P<0.05); the final birth weight (FBW) of the children in the observation group was significantly lower than that of the control group (t=6.261, P<0.001); the 24-hour urine protein quantification was significantly higher in the observation group than in the control group (t=2.986, P<0.001); all patients in the observation and control groups had significantly higher SBP blood pressure load values and DBP blood pressure load values at night than during the day (P<0.001). Conclusion: Patients with pre-eclampsia have a high incidence of abnormal circadian rhythms, characterized by non-arrythmic circadian rhythms and elevated blood pressure at night, and ambulatory blood pressure and proteinuria monitoring can indicate adverse pregnancy outcomes.

Key words： Preeclampsia Ambulatory blood pressure monitoring 24-hour urinary protein quantification Pregnancy outcome

基金资助:安徽省中央引导地方科技发展科技创新项目示范类项目,(编号:201707d08050003);安徽省临床重点专科建设项目,(编号:201730)

通讯作者: 韩卫星

引用本文:

叶萍, 陈红波, 黄翔燕, 张敏, 王晓丹, 韩卫星. 动态血压联合24小时尿蛋白定量监测在子痫前期及其妊娠结局中的应用价值[J]. 河北医学, 2022, 28(8): 1357-1360.
YE Ping, CHEN Hongbo, HUANG Xiangyan, et al. The Value of Ambulatory Blood Pressure Combined with Quantitative 24-Hour Urine Protein Monitoring in Pre-Eclampsia and Its Pregnancy Outcome. HeBei Med, 2022, 28(8): 1357-1360.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.08.026 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I8/1357