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目的:探讨轻、重度先兆子痫患者肝肾功能指标的变化及其临床意义。方法:对152例先兆子痫患者的肝功能指标白蛋白(Alb)、球蛋白(GT)、谷丙转氨酶(ALT)、谷草转氨酶(AST)和163例先兆子痫患者的肾功能指标尿素氮(BUN)、尿酸(UA)、肌酐(Cr)进行了回顾性分析,并对先兆子痫患者肝酶水平与母儿预后的关系及血清UA水平与围产儿预后的关系进行了研究。结果:重度先兆子痫患者血清中Alb、GT明显低于轻度先兆子痫患者(P<0.01),ALT、AST明显高于轻度先兆子痫患者(P<0.01);先兆子痫患者中肝酶异常与肝酶正常者新生儿窒息、围产儿死亡、产后出血发生率及新生儿体重差异均无统计学意义(P>0.05);重度先兆子痫患者UA、Cr水平明显高于轻度先兆子痫患者(P<0.01);围产儿死亡发生率随UA水平升高而升高(P<0.05)。结论:重度先兆子痫患者肝肾功能有一定损害,肝酶异常对母儿预后的影响不明显。先兆子痫孕妇的血清UA与围产儿预后密切相关,可作为判断围产儿预后及终止妊娠的一项参考指标。
Objective: To investigate the changes of liver and kidney function in patients with mild and severe preeclampsia and its clinical significance. Methods: The renal function indexes such as albumin (Alb), globulin (GT), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and 163 patients with preeclampsia in 152 patients with preeclampsia were measured. (BUN), uric acid (UA) and creatinine (Cr) were analyzed retrospectively. The relationship between serum liver enzymes and maternal and fetal prognosis in patients with preeclampsia and the relationship between UA and prognosis were investigated. Results: The levels of Alb and GT in patients with severe preeclampsia were significantly lower than those with mild preeclampsia (P <0.01), ALT and AST were significantly higher than those with mild preeclampsia (P <0.01), and those with preeclampsia No significant difference was found in the incidence of neonatal asphyxia, perinatal death, postpartum hemorrhage and weight of neonates with abnormal hepatic enzymes and normal liver enzymes (P> 0.05). The levels of UA and Cr in patients with severe preeclampsia were significantly higher than those with mild Preeclampsia (P <0.01). The incidence of perinatal death increased with the increase of UA (P <0.05). Conclusion: The liver and kidney function of patients with severe preeclampsia have some damage. The abnormal effect of liver enzymes has no obvious effect on the prognosis of maternal and infant. Serum UA in pregnant women with preeclampsia is closely related to the prognosis of perinatal children and can be used as a reference index to judge the prognosis and termination of pregnancy.