摘要
目的:探讨妊娠相关性肾损伤的病因、发生率、预后转归。方法:采用回顾性分析方法调查2004年9月～2007年8月期间2988例住院妊娠患者在妊娠过程中肾损伤的发生情况。结果:75例妊娠患者存在肾损伤,占2.58%,22例为肾脏病合并妊娠。轻度肾损伤组血浆白蛋白显著高于重度肾损伤组(P值均<0.001)。各组间总胆固醇与三酰甘油差异均无统计学意义(P>0.05)。轻度肾损伤组血红蛋白水平显著高于重度肾损伤组(P<0.01),但轻度与中度肾损伤组间、中度与重度肾损伤两组间差异无统计学意义(P>0.05)。与中度肾损伤组和重度肾损伤组相比,轻度肾损伤组SBP(P值分别为0.001,0.002)、DBP(P值分别为0.022,0.009)及MBP(P值分别为0.005,0.004)差异均有统计学意义,但中度肾损伤组与重度肾损伤组间差异无统计学意义。29例资料完整患者Scr均值由妊娠初期时的(176.97±108.83)μmol/L上升到妊娠后期的(193.69±148.63)μmol/L(P<0.001);MBP均值由妊娠前期的(97.00±10.91)mmHg上升到后期的(119.94±19.00)mmHg(P<0.001)。发生子痫前期的患者共有37例(49%),其中轻度肾损伤组24例(42%),中度肾损伤组7例(58%),重度肾损伤组6例患者都存在着子痫前期。9例资料完整的患者中,肾小球滤过率(1/Scr)在妊娠晚期比早期下降的有14例(48%),其中有4例肾小球滤过率严重下降(超过25%)。结论:妊娠相关肾损伤并不少见,可随着妊娠而进展,值得关注和研究。
Objective：To explore the causes,incidence,prognosis and outcome of renal injury pertinent to pregnancy.Methods：A retrospective analysis was adopted on 2 988 cases of pregnancy from September 2004 to August 2007 and observe the related renal injury.Results：Seventy-five cases out of the total had kidney injury,almost 2.58%,22 cases were kidney diseases complicated pregnancy.Plasma albumin of the mild kidney injury group were higher than that of the severe renal injury group （P〈0.001 for all）.The total cholesterol （TC） （P〉0.05）and the triglyceride （TG） （P〉0.05） among groups had no statistical significance.Hemoglobin in the mild kidney injury group was far more than that in the severe renal injury group （P〈0.001）,but it did not have statistic significance either between the mild and moderate injury groups（P0〉.05） or between the moderate and severe injury groups（P〉0.05）.Compared to moderate and severe injury groups,the mild group had great distinctions in the levels of SBP （P=0.001,0.002）,DBP（P=0.022,0.009） and MBP （P=0.005,0.004）.However,there is no such distinction statistically between the moderate and severe injuries.In 29 completely-recorded cases,the pregnancy patients＇ ratios changed along the course of pregnancy：Scr on average changed from （176.97±108.83）μmol/L at the early phase of pregnancy to（193.69±148.63）μmol/L（P0.001）at the later;MBP on average increased from （97.00±10.91）mmHg to （119.94±19.00）mmHg （P〈0.001）.There were 37 cases with preeclampsia （49%）,in which 24 were with mild renal injuries （42%）,7 moderate injuries （58%）,6 severe renal injuries.Nine cases with complete information indicated that glomerular filtration rate fell down （1/Scr）.14（48%） cases showed this decrease in the late phase of pregnancy,in which 4 cases suffered severe decrease of glomerular filtration rate （over 25%）.Conclusion：Renal injury associated to pregnancy was not rare and it developed along the course of pregnancy.
出处
《中国中西医结合肾病杂志》
2010年第5期427-430,共4页
Chinese Journal of Integrated Traditional and Western Nephrology
关键词
妊娠
肾损伤
肾功能
Pregnancy Renal injury Renal function
