妊娠期高血压疾病患者肾功能监测临床意义.docVIP

妊娠期高血压疾病患者肾功能监测临床意义摘 要 目的：通过检测血清尿素氮(Bun)、肌酐(Cr)及尿酸(UA)，探讨妊娠高血压疾病的肾功能改变情况及肾功能损害对胎儿的影响。方法：采用全自动生化分析仪，分别对72例妊娠高血压疾病患者(研究组)及74例正常孕妇(对照组)测定Bun、Cr及UA，并跟踪肾功能改变对胎儿的影响。结果：妊娠高血压疾病Bun、Cr及UA异常的发生率分别为48.6%、44.4%及61.1%；Bun、Cr及UA异常导致胎儿宫内窘迫的发生率分别为62.9%、75.0%及56.8%。两组统计学比较差异具有显著性(P＜0.05)。结论：Bun、Cr及UA的检测，是诊断妊娠高血压疾病肾功能损害的三项敏感指标，胎儿窘迫的发生与孕妇肾功能损害关系密切。 关键词妊娠高血压疾病 肾功能胎儿窘迫 doi:10.3969/j.issn.1007-614x.2009.09.102 Abstract Objective:To explore the effects of the changes and lesions of renal function on the fetus,serum urea nitrogen (Bun),creatinine (Cr) and uric acid (UA) were detected in the patients with gestational hypertension.Methods:Bun,Cr and UA in serum from 72 patients diagnosed the gestational hypertension and 74 normal pregnant women were detected by the UAtomatic biochemical analyzer ,and the effects on fetus have also been observed by renal function monitoring.Results:The abnormal incidences of Bun,Cr and UA in the patients with gestational hypertension were 48.6%,44.4% and 61.1%,and the incidences of fetal distress cUAsed by Bun,Cr and UA abnormality were 62.9%,75.0% and 56.8% respectively.Conclusions:Bun,Cr and UA were three sensitive indicators to diagnose the renal function lesion in gestational hypertension,and there was an intimate relation between the occurrence of fetal distress and renal function lesion in the pregnant women. Keywords gestational hypertension;renal function;fetal distress 妊娠期高血压疾病可引起肾功能的损害，而肾功能不全又是引起流产、早产、甚至死胎的原因之一[1]，所以对妊娠期肾功能的变化要引起足够的重视。为探讨妊娠期高血压疾病肾功能变化及对胎儿的影响，我们对72例患病孕妇进行了观察分析，现报告如下。 资料与方法 一般资料：本组研究对象为2005年1月～2008年11月我院收治的72例妊娠高血压疾病患者,并将其做为研究组，患者平均孕龄为29.1岁，平均孕周37.2周。我们再随机选择同期正常妊娠无合并症孕妇74例作为对照组，平均年龄28.5岁，平均孕周38.6周。 方法：所有研究对象均于分娩前清晨抽空腹静脉血5ml，来进行血清肾功能测定。采用仪器为日立7180型全自动生化分析仪，主要观察血清尿素氮(BUN)、肌酐(Cr)、尿酸(UA)的值。按临床诊疗指南妇产科分册[2]分别以BUN≥4.64mmol/L、Cr≥79.6μmol/L及UA≥350μmol/L为阳性标准。妊娠高血压疾病以高血压(BP≥140/90mmHg)、尿蛋白(+)以上、浮肿(+)以上做为诊断依据。胎儿窘迫主要以胎心率异常(＞160次/分或＜120次/分)、羊水胎粪污染Ⅱ度以上及胎儿酸中毒(脐动脉血pH＜7.20)为诊断依据。 统计学方法：应用SPSS11.0统计软件分析，计数资料用X2检验，组间比较用t检验。