妊娠相关肾损伤的临床调查研究(1)
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[摘要] 目的 对妊娠的相关肾损伤进行调查，了解其发生原因和发生情况及疾病的预后情况。方法 对我院住院的2650例妊娠患者的资料进行回顾性分析，对妊娠过程中发生肾损害情况进行了解。结果 有65例发生肾损伤。血浆白蛋白轻度肾损伤组与中度及重度组、血红蛋白轻度组与重度组、SBP及DBP和MBP轻度组与其他两组均有显著性差异(P<0.05)。有23例患者资料完整，其妊娠后期的Scr、MBP均值较初期明显升高(P<0.05)。有32例患者发生子痫前期。结论 妊娠肾损害随着妊娠时间的延长而发展，应引起医务工作者的广泛关注。
[关键词] 妊娠；肾脏损害；肾功能；妊娠综合征
[中图分类号] R714.25 [文献标识码] B [文章编号] 1673-9701(2011)34-14-03
Pregnancy-related Renal Injury Investigation and Clinical Analysis
YANG Hong
Tiantai County Hospital of TCM in Zhejiang Province, Tiantai 317200, China
[Abstract] Objective To investigate the pregnancy-related kidney damage, the occuttence，the reasons and disease prognosis. Methods There were 2650 of pregnantwomen in our hospital, the data were retrospectively analyzed, kidney damage from occurring during pregnancy to understand the situation. Results There were 65 cases with renal impairment. Compared with moderate and severe plasma albumin, the mild group was significantly higher(P<0.05)；Compared with severe group with the hemoglobin,mild group was significantly higher(P<0.05). There were significant difference in SBP, DBP, MBP between the mild renal impairment group and the other two groups. Scr and MBP of 23 patients were significantly higher in late pregnancy than those of the early (P<0.05). Total of 32 patients (49.23%) developed preeclampsia. Conclusion Pregnancy kidney damage as the extension of the development of pregnant time, should pay more attention to medical workers.
[Key words] Pregnancy; Kidney damage; Renal function; Pregnancy syndrome
妊娠期妇女常在妊娠期间出现妊娠高血压综合征等并发症，有可能使患者出现肾损伤或对其产生促进作用。妊娠肾损伤对于妊娠患者来讲是一种高危的因素，严重影响妊娠妇女的生命安全[1]。本研究对2008～2010年期间在我院住院的2650例妊娠患者的临床资料进行回顾性分析，了解妊娠相关肾损伤发生原因和情况及疾病的预后。
1 资料与方法
1.1 研究对象
研究对象为2008~2010年期间在我院住院的2650例妊娠妇女。妊娠妇女的慢性肾脏疾病合并妊娠与发生在妊娠后的肾损伤均为妊娠相关肾损伤。参照相关文献[2]肾损伤定义为孕妇血清肌酐(Scr)水平在70μmol/L或以上，将妊娠过程肾损伤以血清肌酐水平为依据按照不同的程度分为轻度、中度、重度肾损伤组：血清肌酐水平为(70~123)μmol/L的患者为轻度肾损伤组、血清肌酐水平为(124~220)μmol/L的患者为中度肾损伤组，血清肌酐水平大于221μmol/L为重度肾损伤组。肾小球滤过率的判定指标为1/Scr。
1.2 研究方法
调查所得结果用表格详细登记，具体内容：患者的病史，血、尿常规、24h尿蛋白定量、肝肾功能、血压及血脂、妊娠结局及胎儿预后等，采取何种治疗方案也要作详细记录。
1.3 统计学方法
数据的统计学分析采用SPSS11.5软件进行，计量资料以均数±标准差表示，多组间计量资料的比较采用方差分析，组间的两两比较行t检验，计数资料的比较行卡方检验。P<0.05为组间有显著性差异。
2 结果
2.1 一般情况分析
本次调查的2650例妊娠患者中肾损伤患者65例(2.45%)。23例(35.38%，23/65)患者在妊娠初期与妊娠后期有完整的Scr及血压资料 ......
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