文档介绍：上海交通大学
硕士学位论文
妊娠与肾脏损伤的临床研究
姓名:邢涛
申请学位级别:硕士
专业:内科学(肾内科)
指导教师:汪年松
20080501
妊娠与肾脏损伤的临床研究

摘要

研究背景和目的肾脏病是异常妊娠的危险因素之一妊娠可以
加重原有肾脏损伤的病情发展先兆子痫引起的肾脏的血管损伤是最
常见的妊娠并发症且在既往有肾脏病及高血压病史的患者中妊娠
有可能使原有肾功能进一步恶化导致胎儿的死亡率及发病率高于正
常妊娠的妇女本课题采用回顾性研究方法分析了住院妊娠患者在
妊娠过程中肾损伤的发生情况探讨妊娠相关性肾损伤的病因发生
率预后转归及其对于母子的影响为妊娠相关性肾损伤的早期诊断
及防治提供依据
方法回顾性研究了自年月至年月三年间上海交
通大学附属第六人民医院产科住院的例妊娠妇女中以血清
肌酐水平为肾脏损伤的标准的住院病例例同时分析
在此期间肾脏科收治因妊娠而发生肾脏损伤并且行肾穿刺活检的病
例例
结果在中重度肾损伤的患者中出现大量蛋白尿的比例明显增
高轻度肾损伤组中占中度肾损伤组中占重度肾损伤组
中占收缩压三组分别为
舒张压三组分别为
及平均动脉压三组分别为
在中重度肾损
伤组中明显升高产科并发症包括早产胎儿宫内窘迫
的发病率升高但总的新生儿存活率经单因素分析高血压中
重度妊娠高血压综合征的发生蛋白尿大量蛋白尿和低蛋白血症可
能导致不良妊娠结果相关但在多因素回归分
析中没有发现明显的统计学差异在对分娩引产前后有对照的亚
组分析中有分娩前的上升至
平均动脉压由上升至
并有例患者在引产后不久迅速进
入到终末期肾病例患者因妊娠促发狼疮性肾炎
结论
我院自年月至年月三年间产科孕妇发生肾脏损
的发病率为
在的患者中妊娠并发症相对较少孕妇往往
都能成功分娩妊娠结果相对较理想
在的患者中随着肾功能的恶化妊娠并发症
明显升高高血压贫血大量蛋白尿等产科并发症也相对增高

关键词肾损伤妊娠高血压肌酐蛋白尿
Pregnancy in Kidney Injury

ABSTRACT

Background and Objective: Among all the risk factors to
abnormal pregnancy, the underlying renal failure of pregnant
women can be worsened. The vascular injury of kidney due to
preeclampsia is the plications of pregnancy.
The renal function can be deteriorated among the patients with
underlying renal diseases or hypertension because of the impact of
pregnancy. Further more, the fetal morbidity and mortality surge
compared with normal pregnancy. The purpose of this study was
to examine the etiology, incidence, progression and prognosis of
maternal and plications and the es of
pregnancy in women with renal injury, in order to provide evidence
for early diagnosis and protection of kidney injury associated with
pregnancy.
Method: We retrospectively analyzed the 2988 women
admitted to department of obstetrics of No. 6 People’s Hospital
affiliated to Shanghai Jiaotong University from Aug 2004 to Aug
2007. All the 73 patients who were included in the study had
serum creatinine concentrations of at least 70 umol