CAJ | 학술논문

目的：探讨妊娠原发性高血压对新生儿多系统的影响。方法随机选择2011年12月至2012年12月收治的母亲妊娠合并原发性高血压的新生儿100例，根据母亲妊娠期血压，分为子痫前期组53例、妊娠高血压组47例；另选取同期收治的健康母亲新生儿100例为对照组(足月儿12例，无诱因早产儿88例)。比较各组新生儿出生时体质量、身长、头围、Apgar评分、羊水污染、胎盘早剥、宫内窘迫情况、神经发育评分、血清肌酸激酶、肺动脉压力、甲状腺功能、血糖、血常规、头颅磁共振(MRI)等资料。结果三组新生儿的出生胎龄、出生体质量、头围、1分钟和5分钟Apgar评分以及低出生体质量儿比例的差异有统计学意义(P均<0.05)，前5项指标均以子痫前期组最低，且子痫前期组的低出生体质量儿比例最高。三组新生儿产前异常(羊水III度污染、胎盘早剥、宫内窘迫)以及并发症(重症感染、心肌损伤、红细胞增多症、肝肾功能损伤、低血糖症、甲状腺功能减退症、呼吸衰竭等)发生率的组间差异有统计学意义(P均<0.01)，均以子痫前期组的发生概率最高。子痫前期组的红细胞计数、血红蛋白、红细胞比容(HCT)、促甲状腺激素(TSH)水平较其他两组升高，而白细胞和血小板计数低于对照组，差异有统计学意义(P均<0.05)。子痫前期组的被动肌张力评分低于妊娠高血压组及对照组，差异有统计学意义(P均<0.05)。三组新生儿头颅MRI异常率的差异有统计学意义(P=0.000)，以子痫前期组异常率最高。结论母亲妊娠原发性高血压可造成胎儿宫内生长发育迟缓、内分泌系统紊乱、心功能减退、血液黏滞度增加、神经发育迟缓；母病情愈重，对新生儿各系统影响愈大。
목적：탐토임신원발성고혈압대신생인다계통적영향。방법수궤선택2011년12월지2012년12월수치적모친임신합병원발성고혈압적신생인100례，근거모친임신기혈압，분위자간전기조53례、임신고혈압조47례；령선취동기수치적건강모친신생인100례위대조조(족월인12례，무유인조산인88례)。비교각조신생인출생시체질량、신장、두위、Apgar평분、양수오염、태반조박、궁내군박정황、신경발육평분、혈청기산격매、폐동맥압력、갑상선공능、혈당、혈상규、두로자공진(MRI)등자료。결과삼조신생인적출생태령、출생체질량、두위、1분종화5분종Apgar평분이급저출생체질량인비례적차이유통계학의의(P균<0.05)，전5항지표균이자간전기조최저，차자간전기조적저출생체질량인비례최고。삼조신생인산전이상(양수III도오염、태반조박、궁내군박)이급병발증(중증감염、심기손상、홍세포증다증、간신공능손상、저혈당증、갑상선공능감퇴증、호흡쇠갈등)발생솔적조간차이유통계학의의(P균<0.01)，균이자간전기조적발생개솔최고。자간전기조적홍세포계수、혈홍단백、홍세포비용(HCT)、촉갑상선격소(TSH)수평교기타량조승고，이백세포화혈소판계수저우대조조，차이유통계학의의(P균<0.05)。자간전기조적피동기장력평분저우임신고혈압조급대조조，차이유통계학의의(P균<0.05)。삼조신생인두로MRI이상솔적차이유통계학의의(P=0.000)，이자간전기조이상솔최고。결론모친임신원발성고혈압가조성태인궁내생장발육지완、내분비계통문란、심공능감퇴、혈액점체도증가、신경발육지완；모병정유중，대신생인각계통영향유대。
Objective To explore the effect of gestational hypertension on multiple organ system in neonates. Methods A total of 100 newborns whose mother had pregnancy complicating primary hypertension admitted to our hospital from December 2011 to December 2012 were selected and divided into preeclampsia group (n=53), gestational hypertension group (n=47) according to the blood pressure during pregnancy. Meanwhile, 100 newborns with healthy mother were selected as control group including 12 term infants and 88 premature infants. Data including birth weight, length and head circumference, Apgar score, the percentage of amniotic lfuid pollution, placental abruption and fetal distress, Neonatal Behavioral Neurological Assessment (NABA) score, serum level of creatine kinase, pulmonary arterial pressure, thyroid function, blood glucose, blood routine, cranial MRI parameters were collected and compared among three groups. Results In preeclampsia group, the gestational age, birth weight and head circumference, 1-min and 5-min Apgar scores were lowest while the ratio of low birth weight infants was highest among three groups, and the differences were signiifcant (P<0.05). In preeclampsia group, the rates of antenatal abnormalities (amniotic lfuid meconium III degree pollution, placental abruption and fetal distress) and complications (severe infection, myocardial damage, neonatal polycythemia, liver and kidney damage, hypoglycemia, hypothyroidism and respiratory failure) were highest among three groups, and the differences were signiifcant (P<0.01). In preeclampsia group, the red blood cell count, the levels of hemoglobin, hematocrit and thyroid stimulating hormone were signiifcantly higher than those in the other two groups ( P<0.05 ), and the white blood cell and platelet count was signiifcantly lower than that in the control group (P<0.05). The passive muscle tension scores in preeclampsia group were signiifcantly lower than those in the other two groups (P<0.05).The abnormity rate of cranial MRI in preeclampsia group was highest among three groups, and the difference was signiifcant (P<0.01). Conclusions Gestational hypertension may cause multisystem disorders in newborns, such as fetal intrauterine growth restriction, endocrine system disorders, heart dysfunction, increased blood viscosity, delayed neurodevelopment. The severity of gestational hypertension is associated with the adverse impact on the multiple systems in neonates.