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中华产科急救电子杂志

中华产科急救电子杂志 ›› 2022, Vol. 11 ›› Issue (03) : 152 -157. doi: 10.3877/cma.j.issn.2095-3259.2022.03.007

论著

新疆不同民族妊娠期高血压疾病患者1162例临床分析
武建利1, 张丽姿2, 李玲1, 单婷3, 王晓燕4, 卢瑛5, 许君君6, 沈霞7, 佐合热古丽·赛麦提8, 石纪红9, 朱启英1,†(), 杜丽丽10,†()   
  1. 1. 新疆医科大学第一附属医院产科，乌鲁木齐　830054
    2. 南方医科大学南方医院妇产科，广州　510515
    3. 克拉玛依市中心医院产科，834000
    4. 阿勒泰地区人民医院产科，836500
    5. 呼图壁县人民医院产科，831200
    6. 博尔塔拉蒙古自治州人民医院产科，833400
    7. 新疆生产建设兵团第二师库尔勒医院产科，841001
    8. 新疆医科大学第一附属医院昌吉分院产科，831100
    9. 焉耆县妇幼保健计划生育服务中心孕产保健部，841100
    10. 广州医科大学附属第三医院妇产科，广东省产科重大疾病重点实验室，广州重症孕产妇救治中心，510150
  • 收稿日期:2021-11-20 出版日期:2022-08-18
  • 通信作者: 朱启英, 杜丽丽
  • 基金资助:
    新疆维吾尔自治区自然科学基金(2020D01C244)

Clinical analysis of 1162 cases of hypertensive disorders of pregnancy in Xinjiang

Jianli Wu1, Lizi Zhang2, Ling Li1, Ting Shan3, Xiaoyan Wang4, Ying Lu5, Junjun Xu6, Xia Shen7, Saimaiti Zuohereguli·8, Jihong Shi9, Qiying Zhu1,†(), Lili Du10,†()   

  1. 1. Department of Obstetrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
    2. Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
    3. Department of Obstetrics, Karamay Central Hospital, Karamay 834000, China
    4. Department of Obstetrics, Altay Regional People′s Hospital, Altay 836500, China
    5. Department of Obstetrics, Hutubi County People′s Hospital, Changji 8312000, China
    6. Department of Obstetrics, Boltala Mongolian Autonomous Prefecture People′s Hospital, Bole 833400, China
    7. Department of Obstetrics, Second Division Hospital of Xinjiang Production and Construction Corps, Korla 841001, China
    8. Department of Obstetrics, Changji Branch, The First Affiliated Hospital of Xinjiang Medical University, Changji 831100, China
    9. Ministry of Maternal Health, Yanji County Maternal and Child Health Care Family Planning Service Center, Korla 841100, China
    10. Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou Medical Center for Critical Pregnant Women, Guangzhou 510150, China
  • Received:2021-11-20 Published:2022-08-18
  • Corresponding author: Qiying Zhu, Lili Du
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武建利, 张丽姿, 李玲, 单婷, 王晓燕, 卢瑛, 许君君, 沈霞, 佐合热古丽·赛麦提, 石纪红, 朱启英, 杜丽丽. 新疆不同民族妊娠期高血压疾病患者1162例临床分析[J]. 中华产科急救电子杂志, 2022, 11(03): 152-157.

Jianli Wu, Lizi Zhang, Ling Li, Ting Shan, Xiaoyan Wang, Ying Lu, Junjun Xu, Xia Shen, Saimaiti Zuohereguli·, Jihong Shi, Qiying Zhu, Lili Du. Clinical analysis of 1162 cases of hypertensive disorders of pregnancy in Xinjiang[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2022, 11(03): 152-157.

目的

了解新疆不同民族间妊娠期高血压疾病的临床特点。

方法

收集2018年1月至12月新疆维吾尔自治区8家医院诊断为妊娠期高血压疾病且终止妊娠的1162例患者临床资料，采用回顾性研究方法，根据患者民族分为汉族妊娠期高血压疾病组637例，哈萨克族201例，其他少数民族324例。分析不同民族间妊娠期高血压疾病发病率及临床特点。

结果

汉族妊娠期高血压疾病发病率为5.38%，哈萨克族16.89%，其他少数民族9.91%；哈萨克族妊娠期高血压疾病患者与汉族及其他少数民族在转诊比例(33.3%、17.1%、17.9%, χ2＝26.397)、妊娠34周之前发病比例(47.3%、34.7%、37.0%, χ2＝10.343)、随机尿蛋白(+++)的比例(31.8%、20.3%、21.9%, χ2＝31.634)、子痫前期及子痫患者比例(74.6%、55.3%、60.5%, χ2＝24.064)、剖宫产分娩比例(86.1%、78.0%、77.5%, χ2＝6.896)、最高收缩压[(158.78±17.33)mmHg、(152.18±16.20)mmHg、(153.13±18.87)mmHg，t＝11.434)]、最高舒张压[(101.11±12.37)mmHg、(97.91±12.18)mmHg、(98.62±12.74)mmHg，t＝5.142]、终止妊娠孕周[(34.82±4.07)周、(36.44±3.26)周、(35.86±4.12)周，t＝15.335]等方面比较，差异均有统计学意义(P<0.05)。

结论

妊娠期高血压疾病在新疆不同民族间发病率及临床表现存在差异。

关键词: 高血压，妊娠性, 发病率, 人种群
Objective

To analyze the clinical characteristics of hypertensive disorders of pregnancy among different nationalities in XinJiang.

Methods

A total of 1162 patients who were diagnosed with hypertensive disorders during pregnancy and delivered were recruited from 8 hospitals in Xinjiang province between January and December 2018. A retrospective analysis was applied to identify the incidence and clinical characteristics of hypertensive disorders of pregnancy among different nationalities. There were 637 Han patients with hypertensive disorders of pregnancy, 201 kazakh patients, 324 other ethnic minorities patients.

Results

The incidence rate of hypertensive disorders during pregnancy was 5.38% for Han nationality, 16.89% for Kazakh nationality, and 9.91% for other ethnic minorities respectively. Clinical manifestations of Kazakh patients with hypertensive disorders of pregnancy, including referral ratio (33.3%、17.1%、17.9%、χ2=26.397), incidence ratio before 34 weeks of gestation (47.3%、34.7%、37.0%, χ2=10.343), random urine protein (+ + + ) ratio (31.8%、20.3%、21.9%, χ2=31.634), the ratio of patients diagnosed with preeclampsia and eclampsia (74.6%、55.3%、60.5%, χ2=24.064), cesarean section terminated pregnancy rate (86.1%、78.0%、77.5%, χ2=6.896), systolic blood pressure [(158.78±17.33) mmHg、(152.18±16.20) mmHg、(153.13±18.87) mmHg, t=11.434], and diastolic blood pressure [(101.11±12.37) mmHg、(97.91±12.18) mmHg、(98.62±12.74) mmHg, t=5.142], terminated gestational age [(34.82±4.07) weeks、(36.44±3.26) weeks、(35.86±4.12) weeks, t=15.335] were more serious than those of Han and other ethnic minorities, and the differences were statistically significant(P<0.05).

Conclusions

There are differences in the incidence and clinical manifestations of hypertensive disorders during pregnancy among different nationalities in Xinjiang.

Key words: Hypertension, pregnancy-induced, Incidence, Ethnic groups
表1 8家医院不同民族患者妊娠期高血压疾病发病率[发病率(患病例数/分娩例数)]
医院名称 汉族 哈萨克族 其他少数民族
克拉玛依市中心医院 6.75%(103/1527) 19.40%(26/134) 11.67%(49/420)
新疆医科大学第一附属医院 5.17%(239/4623) 40.00%(74/185) 19.88%(160/805)
阿勒泰地区人民医院 0.59%(1/169) 9.92%(26/262) 2.63%(1/38)
呼图壁县人民医院 3.82%(25/654) 6.75%(17/252) 1.50%(3/200)
博尔塔拉蒙古自治州人民医院 7.83%(79/1009) 16.05%(48/299) 8.49%(57/671)
新疆生产建设兵团第二师库尔勒医院 3.69%(66/1788) 　0(0) 　 0(0/87)
新疆医科大学第一附属医院昌吉分院 7.52%(111/1477) 19.23%(10/52) 8.63%(24/278)
焉耆县妇幼保健院 2.16%(13/601) 　 0(0/6) 3.89%(30/771)
表2 三组患者临床资料比较
组别 例数 子痫前期及子痫[例(%)] 剖宫产分娩[例(%)] 新生儿体重(g，±s) 随机尿蛋白(+++)[例(%)] 终止妊娠孕周(周，±s)
汉族 637 352(55.3) 497(78.0) 2838.06±880.54 129(20.3) 36.44±3.26
哈萨克族 201 150(74.6) 173(86.1) 2524.42±992.04 64(31.8) 34.82±4.07
其他少数民族 324 196(60.5) 251(77.5) 2807.72±1010.30 71(21.9) 35.86±4.12
统计值   χ2＝24.064 χ2＝6.896 t＝8.299 χ2＝31.634 t＝15.335
P值   0.000 0.032 0.001 0.000 0.018
组别 例数 外院转诊[例(%)] 妊娠34周前发病[例(%)] 最高收缩压(mmHg，±s) 最高舒张压(mmHg，±s)
汉族 637 109(17.1) 221(34.7) 152.18±16.20 97.91±12.18
哈萨克族 201 67(33.3) 95(47.3) 158.78±17.33 101.11±12.37
其他少数民族 324 58(17.9) 120(37.0) 153.13±18.87 98.62±12.74
统计值   χ2＝26.397 χ2＝10.343 t＝11.434 t＝5.142
P值   0.000 0.006 0.001 0.006
表3 妊娠34周前发病三组患者临床资料比较
组别 例数 外院转诊[例(%)] 终止妊娠孕周(周，±s) 最高收缩压(mmHg，±s) 随机尿蛋白(+++)[例(%)] 出现母儿严重并发症[例(%)] 新生儿体重(g，±s) 诊断子痫前期+子痫[例(%)]
汉族 221 58(26.2) 33.81±3.88 159.47±18.63 83(37.6) 66(29.9) 2165.37±981.04 144(65.2)
哈萨克族 95 40(42.1) 31.75±3.72 166.26±17.24 49(51.6) 42(44.2) 1779.89±802.30 78(82.1)
其他少数民族 120 34(28.3) 32.52±4.85 159.23±20.86 41(34.2) 47(39.2) 2043.15±1094.25 79(65.8)
统计值   χ2＝32.022 t＝9.455 t＝4.886 χ2＝13.798 χ2＝6.913 t＝4.855 χ2＝11.692
P值   0.001 0.010 0.008 0.032 0.032 0.008 0.020
表4 妊娠34周后发病三组患者临床资料比较[例(%)]
组别 例数 外院转诊 诊断子痫前期+子痫
汉族 416 51(12.3) 208(50.0)
哈萨克族 106 27(25.5) 72(67.9)
其他少数民族 204 24(11.8) 117(57.4)
χ2值   50.189 15.783
P值   0.000 0.003
[1]
Khedagi AM, Bello NA. Hypertensive Disorders of Pregnancy [J]. Cardiol Clin, 2021, 39(1)：77-90.
[2]
American College of Obstetricians and Gynecologists. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin Summary, Number 222 [J]. Obstet Gynecol, 2020, 135(6): 1492-1495.
[3]
Minhas AS, Ogunwole SM, Vaught AJ, et al. Racial Disparities in Cardiovascular Complications With Pregnancy-Induced Hypertension in the United States [J]. Hypertension, 2021，78(2): 480-488.
[4]
Ding G, Liping L, Moli D, et al. A study of the association between the sFlt-1/PIGF ratio and preeclampsia in Xinjiang Uygur Autonomous Region of China [J]. Artif Cells Nanomed Biotechnol，2018，46(sup3)：S281-S286.
[5]
谢幸，孔北华，段涛. 妇产科学 [M].9版．北京：人民卫生出版社，2018：83-89.
[6]
Nerenberg KA, Zarnke KB, Leung AA, et al. Hypertension Canada′s 2018 Guidelines for the Management of Hypertension in Pregnancy [J]. Can J Cardiol, 2018, 34(5): 526-531.
[7]
Lyu X, Zhang W, Zhang J, et al. Morbidity and maternal and infant outcomes of hypertensive disorder in pregnancy in China in 2018 [J]. J Clin Hypertens (Greenwich), 2021, 23(6): 1194-1204.
[8]
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(2020) [J]. 中华妇产科杂志，2020, 55(4): 227-238.
[9]
Berhe AK, Kassa GM, Fekadu GA, et al. Prevalence of hypertensive disorders of pregnancy in Ethiopia: a systemic review and meta-analysis [J]. BMC Pregnancy Childbirth, 2018, 18(1): 34.
[10]
Bornstein E, Eliner Y, Chervenak FA, et al. Racial Disparity in Pregnancy Risks and Complications in the US: Temporal Changes during 2007－2018 [J]. J Clin Med, 2020, 9(5): 1-11.
[11]
Poon LC, Shennan A, Hyett JA, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention [J]. Int J Gynaecol Obstet, 2019, 145 Suppl 1(1－33.
[12]
聂晓露，付帅，刘玉昆，等. 高龄孕妇合并妊娠期高血压疾病妊娠结局的临床分析[J/CD]. 中华产科急救电子杂志，2020，9(2)：101-105.
[13]
Heizhati M, Wang L, Yao X, et al. Prevalence, awareness, treatment and control of hypertension in various ethnic groups (Hui, Kazakh, Kyrgyz, Mongolian, Tajik) in Xinjiang, Northwest China [J]. Blood Pressure, 2020, 29(5)：276-284.
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