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早发型与晚发型重度子痫前期差异分析。

An analysis of the differences between early and late preeclampsia with severe hypertension.

作者信息

Li X L, Guo P L, Xue Y, Gou W L, Tong M, Chen Q

机构信息

Department of Obstetrics & Gynaecology, First Affiliated Hospital of Xi'an Jiaotong University, China.

Department of Obstetrics & Gynaecology, Third Affiliated Hospital of Sun-Yat Sen University, Guangzhou, China.

出版信息

Pregnancy Hypertens. 2016 Jan;6(1):47-52. doi: 10.1016/j.preghy.2015.12.003. Epub 2015 Dec 17.

Abstract

Preeclampsia is clinically divided into early onset and late onset preeclampsia based on the gestational age at delivery. Although the diagnostic criteria are the same in each subgroup of preeclampsia, it has been suggested that the maternal and perinatal mortalities of early onset and late onset preeclampsia are different. However, studies that compare clinical parameters or laboratory biomarkers between early onset and late onset preeclampsia are limited. Data on 177 women with early or late preeclampsia with severe hypertension were collected from a University Teaching Hospital from January 2010 to January 2011 and analysed. Data included all the clinical parameters and laboratory biomarkers of liver and renal function. 63 women and 114 women were diagnosed with early and late preeclampsia with severe hypertension, respectively. There was no difference in the maternal age and the incidence of clinical symptoms including edema, vision disturbance, severe headache and stillbirth between two groups. There was a decrease in alkaline phosphatase levels in early preeclampsia with severe hypertension but other markers of liver function were not altered. However, renal function including blood urea nitrogen, creatinine and uric acid were significantly higher in early preeclampsia with severe hypertension. Umbilical artery systolic velocity/diastolic velocity ratio was significantly higher in early preeclampsia with severe hypertension. Our data demonstrates that the laboratory biomarkers of renal function differ between early and late preeclampsia with severe hypertension. The severity of renal dysfunction correlated with the time of delivery in preeclampsia with severe hypertension.

摘要

子痫前期根据分娩时的孕周在临床上分为早发型和晚发型子痫前期。虽然子痫前期各亚组的诊断标准相同,但有研究表明早发型和晚发型子痫前期的孕产妇和围产儿死亡率有所不同。然而,比较早发型和晚发型子痫前期临床参数或实验室生物标志物的研究有限。2010年1月至2011年1月期间,从一家大学教学医院收集了177例早发型或晚发型重度高血压子痫前期患者的数据并进行分析。数据包括所有临床参数以及肝肾功能的实验室生物标志物。分别有63例和114例患者被诊断为早发型和晚发型重度高血压子痫前期。两组之间的产妇年龄以及包括水肿、视力障碍、严重头痛和死产在内的临床症状发生率没有差异。早发型重度高血压子痫前期患者的碱性磷酸酶水平降低,但其他肝功能指标未改变。然而,早发型重度高血压子痫前期患者的肾功能指标,包括血尿素氮、肌酐和尿酸显著升高。早发型重度高血压子痫前期患者的脐动脉收缩期速度/舒张期速度比值显著更高。我们的数据表明,早发型和晚发型重度高血压子痫前期患者的肾功能实验室生物标志物存在差异。重度高血压子痫前期患者肾功能障碍的严重程度与分娩时间相关。

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