妊娠合并肺动脉高压的临床特征和母婴结局分析

    Clinical characteristics and maternal and infant outcomes in patients with pregnancy complicated with pulmonary artery hypertension

    • 摘要:
      目的探讨妊娠合并不同程度肺动脉高压(PAH)的临床特征,并分析母婴结局。
      方法选取妊娠合并PAH病人75例,根据肺动脉收缩压(SPAP)分为轻度组36例、中度组21例和重度组18例。比较各组病人的心功能分级、辅助检查指标和母婴结局。
      结果3组病人心功能分级、脑钠肽水平、SPAP差异均有统计学意义(P < 0.01),心肌酶各项指标及左心室射血分数差异均无统计学意义(P>0.05)。3组病人转入ICU比例差异有统计学意义(P < 0.01),妊娠结局、分娩方式和麻醉方式比例差异均无统计学意义(P>0.05)。3组病人的分娩孕周、新生儿体质量和新生儿窒息、转NICU比例差异均有统计学意义(P < 0.01)。
      结论心功能分级、脑钠肽水平以及SPAP与PAH的严重程度有关,临床应关注相关指标;PAH严重程度可能影响母婴结局,临床应及早进行干预。

       

      Abstract:
      ObjectiveTo investigate the clinical characteristics of patients with different degrees of pulmonary artery hypertension(PAH) during pregnancy, and analyze the maternal and infant outcomes.
      MethodsAccording to the level of pulmonary systolic pressure(SPAP), 75 patients with pregnancy complicated with PAH were divided into the mild group(36 cases), moderate group(21 cases) and severe group(18 cases).The cardiac function grading, auxiliary examination indexes and maternal and infant outcomes among three groups were compared.
      ResultsThe differences of the cardiac function grading, and levels of brain natriuretic peptide and SPAP among three groups were statistically significant(P < 0.01), and the differences of the myocardial enzymes and left ventricular ejection fraction among three groups were not statistically significant(P>0.05).The differences of the proportion of transferring to ICU among three groups were statistically significant(P < 0.01), and the differences of the pregnancy outcomes, delivery mode and anesthesia mode among three groups were not statistically significant(P>0.05).The differences of the gestational age, neonatal body mass, neonatal asphyxia and proportion of transferring to NICU among three groups were statistically significant(P < 0.01).
      ConclusionsThe cardiac function grading, BNP and SPAP are related to the severity of PAH.The severity of PAH may affect the maternal and infant outcomes, and the clinical intervention should be conducted as early as possible.

       

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