不同妊娠阶段血压正常和子痫前期孕妇肾功能参数的评价

Farhana Mukhtar
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摘要

先兆子痫是发展中国家产妇和胎儿并发症的最常见原因之一。由于其涉及多系统,高血压和蛋白尿在子痫前期妇女可导致急性或慢性肾功能衰竭。早期诊断对于避免这种器官衰竭至关重要。目的:通过测定和比较不同妊娠阶段子痫前期和血压正常孕妇的血尿素氮(BUN)、血清肌酐、肌酐清除率和24小时尿蛋白等4项肾功能指标来评价其肾功能。研究地点和时间:这项前瞻性和观察性研究于2009年在谢赫扎耶德医院进行。患者均为妊娠24周的妇产科门诊患者。材料与方法:选取血压正常的对照组25例,子痫前期孕妇25例。分别于妊娠24周、28周、32周及足月(38周)采集血清和尿液样本。采用临床化学自动分析仪Dimension AR测定血尿素氮(BUN)、血清肌酐、斑点尿蛋白和尿肌酐,并计算24小时尿蛋白和肌酐清除率。结果:与对照组相比,孕32周和足月时,孕前妇女仅在孕38周时BUN水平显著升高(p0.05)。除其他结果外,与妊娠各阶段血压正常的妇女相比,子痫前期妇女24小时尿蛋白明显高(p<0.05)。结论:我们的研究表明BUN、肌酐清除率和最重要的24小时尿蛋白可用于评估肾功能与子痫前期严重程度的关系。关键词:先兆子痫,血尿素氮,蛋白尿。
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Evaluation of Renal Function Parameters in Normotensive and Pre-Eclamptic Pregnant Women at Different Stages of Pregnancy
Introduction: Pre-eclampsia is one of the most common causes of maternal and fetal complications in developing countries. Owing to its multisystem involvement, hypertension and proteinuria in pre-eclamptic women may lead to acute or chronic renal failure. Early diagnosis is vital to avoid this organ failure. Aims & Objectives: To assess renal function by measuring and comparing four renal function parameters including Blood urea Nitrogen (BUN),serum creatinine, creatinine clearance and 24-hr urinary protein in pre-eclamptic and normotensive pregnant women at different stages of pregnancy. Place and duration of study: This prospective and observational study was conducted in 2009 at Shaikh Zayed Hospital. The patients were taken from Gynae and Obstetrics OPD, with 24 weeks of gestation. Material & Methods: In this study, 25 normotensive Controls and 25 pre-eclamptic pregnant women (cases) were included. Serum and urinary samples were taken at 24 weeks, 28 weeks, 32 weeks of gestation as well as at term (38 weeks). Blood urea nitrogen (BUN), serum creatinine, spot urinary protein and urinary creatinine were measured by clinical Chemistry Auto analyzer Dimension AR. Whereas, 24 hours urinary protein and creatinine clearance were calculated later. Results: BUN level of cases were significantly high as compared to controls at 32 weeks and at term (p<0.01) however creatinine clearance was found to be significantly low (p>0.05) in pre-elamptic women only at 38 weeks. Apart from other results, 24-hours urinary protein was found to be significantly high (p<0.05) in pre-eclamptic women as compared to normotensive women at all stages of pregnancy. Conclusion: Our study showed that BUN, Creatinine clearance and most importantly 24-hr urinary protein may be used to assess the renal function in relation with the severity of pre-eclampsia. Key words: Pre-eclampsia, Blood Urea Nitrogen (BUN), Proteinuria.
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