孕中期血红蛋白水平与妊娠高血压疾病的关系_临床医学论文.docVIP

孕中期血红蛋白水平与妊娠高血压疾病的关系_临床医学论文 孕中期血红蛋白水平与妊娠高血压疾病的关系_临床医学论文 作者：张振 叶荣伟 刘建蒙 杨瑞兰 章斐然 张檀 张静波 任爱国 【摘要】 目的 分析孕中期血红蛋白水平(Hb)与孕晚期妊娠高血压疾病(PIH)之间的关系。 方法 比较1995～2000年浙江省和江苏省4个县(市)单胎分娩的95 620例妇女孕中期不同Hb水平孕妇的PIH发病率;采用logistic回归模型控制年龄、职业、文化程度、产次和体质指数(BMI)等因素后，估计Hb水平与PIH之间的关联程度。 结果 孕晚期及产时孕妇PIH的发病率为9.7 %;Hb水平为100～109 g/L时，PIH的发病率最低;Hb水平升高或者降低，PIH的发病率均呈增加趋势，Hblt;80 g/L的孕妇PIH的发病风险增加79 %(OR=1.79，95 %CI:1.29～2.49)，Hb≥150 g/L的孕妇PIH的发病风险增加47 %(OR=1.47，95%CI:1.00～2.21)。 结论孕中期Hb水平与PIH的发生风险之间呈“U”型关系，重度贫血以及高水平Hb都可能会增加PIH的发生风险。 【关键词】 血红蛋白;贫血;妊娠高血压疾病 　　【Abstract】 Objective To examine the association between secondunties in Jiangsu Province and Zhejiang Province, China, during the period of 19952000. Hb concentration was the lowest concentration measured in the second trimester. A total of 95 620 women were included. PIH was diagnosed according to the criteria proposed by the Second Conference of the Task Force on the Prevention and Care of Pregnancyinduced Hypertension, held in 1983 in Shanghai, China. Incidence of PIH was calculated and compared between groups of women with different concentrations of secondtrimester Hb. Multiple logistic regression was used to address the relationship between secondtrimester Hb concentration and the risk of PIH while controlling for age, occupation, education, parity and BMI. Results The overall PIH incidence was 8.0 %. Women with secondtrimester Hb concentrations of 100109 g/L had lowest PIH incidence. The incidence increased with either increasing or decreasing hemoglobin concentrations. Compared with women with Hb concentrations of 100109 g/L, women with Hb concentrations of lower than 80 g/L had 79 % higher risk (OR=1.79, 95 %CI:1.29-2.49), and women with Hb concentration of 150 g/L or higher had 47% higher risk (OR=1.47,95 %CI:1.00-2.21) of PIH. Conclusion A Ushaped relationship is present between secondtrimester Hb concentration and the risk of PIH. Severe anemia as well as high Hb concentration is associated with an increased risk of PIH. 　　【Key w