中国医药导刊
中國醫藥導刊
중국의약도간
CHINESE JOURNAL OF MEDICAL GUIDE
2013年
6期
978-979
,共2页
血流动力学检测%子痫前期%妊娠期高血压%肾功能%肾小球率过滤
血流動力學檢測%子癇前期%妊娠期高血壓%腎功能%腎小毬率過濾
혈류동역학검측%자간전기%임신기고혈압%신공능%신소구솔과려
Hemodynamic monitoring%Preeclampsia%Gestational hypertension%Renal function%Glomerular filtration rate
目的：探讨子痫前期患者的血流动力学变化与肾功能损害的关系。方法：选择我院2008年8月~2012年5月待产分娩的子痫前期患者284例(子痫前期组),妊娠期高血压患者247例(妊高征组)及正常妊娠孕妇65例(正常组)为研究对象。检测所有孕妇的尿蛋白、血肌酐(Scr)、血尿素氮(BUN)、血尿酸(UA)和肾小球滤过率(GFR)并予比较。以90ml/min·1.73m2为临界值,GFR小于该值的57例患者记为子痫前期伴肾功能损害组(即A组),GFR大于或等于该值的227例患者记为子痫前期无肾功能损害组(即B组),对比两组的血流动力学参数：心率(HR)、心脏指数(CI)、心输出量(CO)、每搏指数(SI)、每搏量(SV)、周围血管阻力指数(SVRI)、周围血管阻力(SVR)、心肌加速度指数(ACI)、速度指数(SV)。结果：子痫前期组出现BUN、UA异常及肾功能损害的发生率显著高于妊高组和正常组(P<0.01)；子痫前期患者Scr、BUN和UA较妊高组、正常组明显身高；而GFR显著降低；子痫前期伴肾功能损害组SBRI、SVR显著高于无肾功能损害组,而CI、CO、SI、SV、VI显著低于无肾功能损害组(P均<0.01)。结论：子痫前期可引起肾功能受损,其孕妇心输出量的降低和外周阻力的增大是发生肾功能受损的重要因素。
目的：探討子癇前期患者的血流動力學變化與腎功能損害的關繫。方法：選擇我院2008年8月~2012年5月待產分娩的子癇前期患者284例(子癇前期組),妊娠期高血壓患者247例(妊高徵組)及正常妊娠孕婦65例(正常組)為研究對象。檢測所有孕婦的尿蛋白、血肌酐(Scr)、血尿素氮(BUN)、血尿痠(UA)和腎小毬濾過率(GFR)併予比較。以90ml/min·1.73m2為臨界值,GFR小于該值的57例患者記為子癇前期伴腎功能損害組(即A組),GFR大于或等于該值的227例患者記為子癇前期無腎功能損害組(即B組),對比兩組的血流動力學參數：心率(HR)、心髒指數(CI)、心輸齣量(CO)、每搏指數(SI)、每搏量(SV)、週圍血管阻力指數(SVRI)、週圍血管阻力(SVR)、心肌加速度指數(ACI)、速度指數(SV)。結果：子癇前期組齣現BUN、UA異常及腎功能損害的髮生率顯著高于妊高組和正常組(P<0.01)；子癇前期患者Scr、BUN和UA較妊高組、正常組明顯身高；而GFR顯著降低；子癇前期伴腎功能損害組SBRI、SVR顯著高于無腎功能損害組,而CI、CO、SI、SV、VI顯著低于無腎功能損害組(P均<0.01)。結論：子癇前期可引起腎功能受損,其孕婦心輸齣量的降低和外週阻力的增大是髮生腎功能受損的重要因素。
목적：탐토자간전기환자적혈류동역학변화여신공능손해적관계。방법：선택아원2008년8월~2012년5월대산분면적자간전기환자284례(자간전기조),임신기고혈압환자247례(임고정조)급정상임신잉부65례(정상조)위연구대상。검측소유잉부적뇨단백、혈기항(Scr)、혈뇨소담(BUN)、혈뇨산(UA)화신소구려과솔(GFR)병여비교。이90ml/min·1.73m2위림계치,GFR소우해치적57례환자기위자간전기반신공능손해조(즉A조),GFR대우혹등우해치적227례환자기위자간전기무신공능손해조(즉B조),대비량조적혈류동역학삼수：심솔(HR)、심장지수(CI)、심수출량(CO)、매박지수(SI)、매박량(SV)、주위혈관조력지수(SVRI)、주위혈관조력(SVR)、심기가속도지수(ACI)、속도지수(SV)。결과：자간전기조출현BUN、UA이상급신공능손해적발생솔현저고우임고조화정상조(P<0.01)；자간전기환자Scr、BUN화UA교임고조、정상조명현신고；이GFR현저강저；자간전기반신공능손해조SBRI、SVR현저고우무신공능손해조,이CI、CO、SI、SV、VI현저저우무신공능손해조(P균<0.01)。결론：자간전기가인기신공능수손,기잉부심수출량적강저화외주조력적증대시발생신공능수손적중요인소。
Objective:To investigate the relationship between hemodynamic alterations and renal impairment in preeclamptic womern.Methods:284 women with preeclampsia(PE),247 women with pregnancy-induced hypertension (PIH),and 65 women with normal pregnancy (NP) who admitted in our hospital were enrolled in this study.The urinary protein excretion,serum creatinine (Scr),blood urea nitrogen (BUN),uric acid (UA),glomerular filtration rate (GFR) of each women were tested and compared.The PE group was subdivided into two groups with or without renal impairment (GFR<90ml/min·1.73 m2,n=57 vs GFR≥90 ml/min/1.73·m2,n= 227).The hemodynamic parameters,namely,heart rate (HR),cardiac index (CI),cardiac output (CO),stroke index (SI),peripheral vascular resistance index (VI) were compared between the two subgroups.Results:The incidence of BUN,UA and GFR abnormality in the PE group were significantly higher than those in the other two groups (P<0.01);The Scr,BUN and UA level in PE group were significantly higher than those in the other two groups (P<0.01),while the GFR was markedly dropped (P<0.01);SVRI and SVR in the renal-impairment PE group were remarkably higher than those in the other group (P<0.01),while maternal SI,SV,CI and CO walues in the renal-impairment PE group were significantly lower than those in the other group (P<0.01).Conclusion:Preeclampsia could lead to renal impairment,which is mainly caused by decreased cardiac output and increased peripheral vascular resistance.
