高龄妊娠期高血压患者的动态血压监测
A Clinical Study of Ambulatory Blood Pressure Monitoring in the Advanced Age Patients with Hypertensive Pregnancy
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摘要:
目的 研究高龄妊娠期高血压患者动态血压的特点, 以及血压对妊娠结局的影响, 探讨动态血压监测在高龄妊娠合并高血压疾病中的临床意义.方法 回顾性分析2016年1月至2017年8月在昆明医科大学第二附属医院产检并住院分娩的妊娠期高血压患者200例, 按照孕妇年龄分为高龄组 (年龄≥35岁, n=100) 、适龄组 (年龄<35岁, n=100) .所有孕妇均于妊娠中、晚期行24 h动态血压检查, 比较2组动态血压参数的差异,以及与妊娠不良结局的关系.结果 高龄组收缩压指标 (24 h平均收缩压、白昼平均收缩压、夜间平均收缩压、白昼收缩压负荷值、夜间收缩压负荷值) 高于适龄组, 差异有统计学意义 (P<0.05) ;高龄组剖宫产、早产儿的发生率高于适龄组, 差异有统计学意义 (P<0.05) ;无论高龄组还是适龄组, 夜间平均舒张压、白昼收缩压负荷值与胎儿生长受限存在相关性, 24 h平均舒张压与早产儿存在相关性.结论 动态血压监测对于高龄妊娠期高血压患者, 在病情诊断、评估、减少不良妊娠结局等方面有着积极意义, 可作为高龄孕妇的产前常规检查.
Abstract:Objective To study the characteristics of ambulatory blood pressure in advanced age patients with hypertension during pregnancy and its effect on pregnancy outcome, and to explore the clinical significance of ambulatory blood pressure monitoring in advanced age women with hypertension.Methods A retrospective analysis from January 2016 to August 2017, in patients with pregnancy induced hypertension in the Second Affiliated Hospital of Kunming Medical University of production inspection and delivery in hospital as the research object, according to the age of pregnant women, they were divided into the advanced age group (35 years of age or older, n=100), and age group (age<35, n=100). All the pregnant women underwent 24-hour ambulatory blood pressure examination in the middle and third trimester of pregnancy to compare the difference of ambulatory blood pressure parameters between the two groups and the relationship between them and the adverse outcome of pregnancy. Results Systolic pressure index of the advanced age group 24 hours average systolic pressure, day mean systolic pressure, night mean systolic pressure, day systolic pressure load value, night systolic pressure load value were higher than the age group, the differences were statistically significant (P<0.05); The incidences of cesarean section and premature infant were higher than thase in the age group, and the differences were was statistically significant (P<0.05). The average diastolic blood pressure andthe day systolic load were correlated with fetal growth restriction in both the aged and age groups, and the 24-hour mean diastolic blood pressure was associated with preterm infants. Conclusions Ambulatory blood pressure monitoring has a positive significance in the diagnosis, evaluation and reduction of adverse pregnancy outcomes in the advanced age patients with hypertensive pregnancy, and can be used as prenatal routine examination for the advanced age pregnant women.
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Key words:
- Advanced age /
- Gestational hypertension /
- Ambulatory blood pressure
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[1] [1]刘晓莉, 阮炎, 刘亚君, 等.14省、自治区、直辖市妇女妊娠年龄与妊娠期高血压疾病关系的探讨[J].中华医学杂志, 2015, 95 (11) :19-22. [2] [2]FALL C H, SACHDEV H S, OSMOND C, et al.Association between maternal age at childbirth and child and adult outcomes in the offspring:a prospective study in five low-income and middle-income countries[J].Lancet Global Health, 2015, 3 (7) :366-377. [3] 中华医学会妇产科学分会妊娠期高血压疾病学组.妊娠期高血压疾病诊治指南 (2015) [J].中华妇产科杂志, 2015, 50 (10) :721-728. [4]国家基本公共卫生服务项目基层高血压管理办公室、基层高血压管理专家委员.国家基层高血压防治管理指南 (2017) [J].中国循环杂志, 2017, 32 (11) :1041-1047. [5]尹宗智, 杨媛媛, 张英, 等.生育政策调整对产妇年龄构成及产后出血发生率的影响[J].现代妇产科进展杂志, 2018, 27 (2) :137-138. [6]杨慧丽, 杨孜.高龄妊娠对母胎结局的影响[J].中华产科急救电子杂志, 2016, 5 (3) :129-131. [7] [7]GILLIS E E, SASSER J M, SULLIVAN J C.Endothelin, sex, and pregnancy:unique considerations for blood pressure control in females[J].Am J Physiol Regul Integr Comp Physiol, 2016, 310 (7) :691-696. [8]马晓燕, 陈莹, 游琴, 等.孕晚期妇女抑郁状况调查及其影响因素[J].昆明医科大学学报, 2016, 37 (3) :35-38. [9]凡秀娥, 魏芳.346例孕晚期初产妇血压变化与年龄及心率的相关性[J].昆明医科大学学报, 2015, 36 (8) :94-96. [10]吴祝如, 古艺儿, 陈宏霞.高龄女性妊娠期高血压疾病对妊娠结局的影响分析[J].中国妇幼健康研究杂志, 2017, 28 (6) :739-740. [11]郑翠仙, 林元, 陈水仙, 等.高龄孕妇妊娠并发症及妊娠结局分析[J].海峡预防医学杂志, 2015, 21 (4) :7-9. [12] [12]FITZPATRICK K E, TUFFNELL D, KURINCZUK J J, et al.Pregnancy at very advanced maternal age:A UK Po Pulati on-based cohort study[J].BJOG Int J Obstet Gy, 2016, 92 (9) :14269-14276. [13]赵捷, 冯玲.高龄孕妇的孕期管理[J].中国实用妇科与产科杂志, 2017, 33 (1) :96-99. [14]杨春燕, 田敏, 许平, 等.孕母妊娠高血压对早产儿结局影响的临床研究[J].中国儿童保健杂志, 2017, 25 (9) :938-941. [15]韩金, 魏柯杰.护理质量持续改进在子痫产妇的急救护理中的应用[J].昆明医科大学学报, 2016, 37 (11) :145-148. [16]刘小玲, 鞠春玲.妊娠合并高血压规范诊治对妊娠结局的影响分析[J].中外医学研究杂志, 2017, 15 (3) :129-131. [17] [17]BULLARBO M, RYLANDER R.Diastolic blood Pressure increase is a risk indicator for Preeclam Psia[J].Arch Gynecol Obstet, 2015, 291 (4) :819-823. [18]官萍萍, 颜建英.动态血压、尿蛋白定量与子痫前期不良妊娠结局的研究[D].福州:福建医科大学, 2015:13-14. [19]潘耀平, 张秀.子痫前期孕妇的孕周和夜间收缩压负荷对母儿不良事件发生的影响[J].中国妇幼保健杂志, 2017, 32 (19) :4622-4624. [20] [20]DENOL T.Home blood pressure measurement and pregnancy[J].Presse Medicale, 2014, 43 (7) :827-830.
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