妊娠高血压病史与心脑血管事件风险增加有关。

Zhao Hai-yan, Chen Xing-wei, Niu Jian-qing, Hou Guo-sheng, Sun Jing, Jin Cheng, Gao Jing-sheng, Zheng Xiao-ming, Wu Shou-ling

Department of Cardiology, Hebei United University, Tangshan, China.

Zhonghua Xin Xue Guan Bing Za Zhi. 2012 Aug;40(8):645-51.

OBJECTIVE

To compare the incidence of cardio-cerebral vascular events between pregnancy induced hypertension (PIH) women and non-PIH(NPIH) women.

METHODS

Ambispective cohort study method was used and 4630 pregnant women giving birth during October 1976 to December 2008 in our hospital and participated the healthy examination between July 2006 and October 2007 at Kailuan medical group were included and divided into PIH group (n = 694) and NPIH group (n = 3936) by the history of PIH. Incidence of cardio-cerebral vascular events (myocardial infarction, cerebral infarction and cerebral hemorrhage) was obtained during follow-up. Multivariable Cox proportional hazards regression models was used to assess the relative risk of cardio-cerebral vascular events.

RESULTS

(1) The follow-up time was 2 to 34 (15.32 ± 7.94) years. (2) The childbearing age, systolic blood pressure and diastolic blood pressure before delivery were significantly higher while gestational weeks and weight of newborn were significantly less in PIH group than in NPIH group (all P < 0.01). Levels of systolic blood pressure, diastolic blood pressure, waist circumference, body mass index, triglyceride, total cholesterol and fasting blood glucose during healthy examination between July 2006 and October 2007 were significantly higher in PIH group than in NPIH group (P < 0.05 or P < 0.01). (3) There were 71 cardio-cerebral vascular events during the follow-up. In PIH group, the incidence rate of cardio-cerebral vascular events, myocardial infarction and cerebral infarction was 20.64%, 11.08% and 8.67%, respectively, while the corresponding incidence rate was 7.82%, 4.02% and 2.67% in NPIH group (all P < 0.01). After adjustment for other traditional cardiovascular risk factors, the risk of total cardio-cerebral vascular events, myocardial infarction and cerebral infarction in PIH group was 2.99 fold (95%CI: 1.80 - 4.95), 3.91 fold (95%CI: 1.71 - 8.91) and 3.96 fold (95%CI: 1.95 - 8.05) higher than in NPIH group.

CONCLUSION

PIH is an independent risk factor for cardio-cerebral vascular events.

目的

比较妊娠高血压综合征（PIH）孕妇和非妊娠高血压综合征（NPIH）孕妇心脑血管事件的发生率。

方法

采用双向队列研究方法，纳入1976年10月至2008年12月在我院分娩且于2006年7月至2007年10月参加开滦医疗集团健康体检的4630例孕妇，根据PIH病史分为PIH组（n = 694）和NPIH组（n = 3936）。随访期间获取心脑血管事件（心肌梗死、脑梗死和脑出血）的发生率。采用多变量Cox比例风险回归模型评估心脑血管事件的相对风险。

结果

（1）随访时间为2至34（15.32±7.94）年。（2）PIH组的生育年龄、分娩前收缩压和舒张压显著高于NPIH组，而孕周和新生儿体重显著低于NPIH组（均P < 0.01）。2006年7月至2007年健康体检期间，PIH组的收缩压、舒张压、腰围、体重指数、甘油三酯、总胆固醇和空腹血糖水平显著高于NPIH组（P < 0.05或P < 0.01）。（3）随访期间共发生71例心脑血管事件。PIH组的心脑血管事件、心肌梗死和脑梗死发生率分别为20.64%、11.08%和8.67%，而NPIH组相应的发生率分别为7.82%、4.02%和2.67%（均P < 0.01）。在调整其他传统心血管危险因素后，PIH组的心脑血管事件、心肌梗死和脑梗死的风险分别比NPIH组高2.99倍（95%CI：1.80 - 4.95）、3.91倍（95%CI：1.71 - 8.91）和3.96倍（95%CI：1.95 - 8.05）。