Page 70 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第42卷第2期
·216 · Journal of Nanjing Medical University（Natural Sciences） 2022年2月

·临床医学·

子痫前期患者 24 h 尿蛋白定量与其不良妊娠结局的相关性临

床研究

瞿 琳，周 欣，殷 茵，孙丽洲 *
南京医科大学第一附属医院产科，江苏 南京 210029

［摘 要］ 目的：回顾性分析子痫前期患者24 h尿蛋白定量与妊娠结局的相关性，为子痫前期诊治提供临床依据。方法：选择
2018年1月—2019年7月在南京医科大学第一附属医院产科收治的子痫前期患者222例，依据24 h尿蛋白定量结果将其分为
轻、中、重度蛋白尿组，并分析各组间临床表现、实验室指标及孕产妇、围生儿不良妊娠结局差异。结果：①临床表现：中、重度
组子痫前期患者的发病孕周明显早于轻度组，临床表现更严重。②实验室指标：血浆白蛋白、血清总胆固醇、乳酸脱氢酶、尿素氮
及肌酐水平在中、重度组中明显上升；与轻度组相比，重度组患者的血小板计数明显下降，天门冬氨酸氨基转移酶、甘油三酯及D⁃
二聚体水平明显上升。③孕产妇不良妊娠结局：中、重度组患者胸腔积液、HELLP综合征及腹腔积液的发生率显著增高。④围生
儿不良结局：医源性早产、胎儿生长受限及新生儿窒息的发生率在中、重度组中显著增高。⑤ROC曲线分析法显示，24 h尿蛋白定
量对孕妇HELLP综合征、胸腹腔积液、医源性早产及胎儿生长受限（FGR）发生有一定的预测价值。结论：24 h尿蛋白定量程度与
HELLP综合征、胸腹腔积液、FGR、医源性早产等母儿不良妊娠结局相关，可以作为子痫前期病情发展的一个观察指标。
［关键词］ 24 h尿蛋白定量；子痫前期；不良妊娠结局
［中图分类号］ R714.24 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）02⁃216⁃06
doi：10.7655/NYDXBNS20220212

A clinical study on the correlation between 24 ⁃ hour urinary protein and its adverse

pregnancy outcome in pre⁃eclampsia
QU Lin，ZHOU Xin，YIN Yin，SUN Lizhou *
Department of Obstetrics，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：The correlation between 24 ⁃ hour urinary protein quantity and pregnancy outcome in patients with
preeclampsia was analyzed retrospectively，which provided clinical basis for diagnosis and treatment of preeclampsia. Methods：Total
222 patients with preeclampsia treated in the First Affiliated Hospital of Nanjing Medical University were selected（diagnosis of
+ 6
gestational age 22~40 weeks）. According to the results of 24 ⁃ hour urinary protein quantification，they were divided into mild
albuminuria group，moderate albuminuria group，and severe albuminuria group. We compared the clinical manifestations，laboratory
indexes and adverse pregnancy outcomes of pregnant women，fetuses and newborns among the three groups. Results：① Clinical
manifestations：the onset of preeclampsia was significantly earlier in the moderate and severe group than that in the mild group，and the
clinical manifestations were more serious. ②Laboratory indexes：plasma albumin，serum total cholesterol，lactate dehydrogenase，urea
nitrogen and creatinine levels increased significantly in the moderate and severe groups；platelet count decreased significantly in the
severe group compared with the mild group，while glutamic oxaloacetic transaminase，triglyceride and D dimer levels increased
significantly in the severe group. ③Maternal adverse pregnancy outcome：the incidence of pleural effusion，HELLP syndrome and
peritoneal effusion in moderate and severe group increased significantly. ④Fetal adverse pregnancy outcome：iatrogenic preterm birth，
fetal growth restriction and neonatal asphyxia increased significantly in moderate and severe groups. ⑤ROC curve analysis showed that
24 ⁃ hour urinary protein quantitative analysis had certain predictive value for HELLP syndrome，pleural effusions and hydroceliac

［基金项目］ 国家自然科学基金（81771603）；江苏省卫生和计划生育委员会“十三五”重点学科；江苏省妇幼健康科研项目
（F201658）；江苏省妇幼卫生健康重点人才（FRC）
∗
通信作者（Corresponding author），E⁃mail：Lizhou_sun@163.com