赖慧超　罗绍芳　谢姗　钟艳兰

【摘要】 目的：探討孕期子痫前期中24 h动态血压监测的应用及孕期血压节律性变化的规律。方法：选取2016年4月-2019年4月50例孕期子痫前期患者作为观察组，另选择同时间60例孕期正常者为对照组。两组患者均进行24 h动态血压监测，比较两组血压相关指标、肾功能、不同严重程度子痫患者24 h血压及围产儿结局。结果：观察组24 h SBP、24 h DBP、dSBP、dDBP、nSBP、nDBP均高于对照组，差异均有统计学意义（P<0.05）。观察组BUN、Scr、SUA均高于对照组，差异均有统计学意义（P<0.05）。轻度子痫前期者24 h平均血压、日间平均血压及夜间平均血压均低于重度子痫前期者，差异均有统计学意义（P<0.05）。观察组母婴不良妊娠结局发生率高于对照组，差异有统计学意义（P<0.05）。结论：通过对孕期子痫前期患者进行24 h动态血压监测，可充分了解患者血压变化，及时采取干预措施并利用24 h动态血压监测了解其治疗的效果，为合理安排治疗及护理操作提供依据，从而降低子痫的发生，确保母婴安全，值得推广应用。

【关键词】 孕期子痫前期 24 h动态血压监测 血压节律性变化规律 肾功能

Application of 24 h Ambulate Blood Pressure Monitoring in Preeclampsia during Pregnancy and the Rhythm Change of Blood Pressure during Pregnancy/LAI Huichao， LUO Shaofang， XIE Shan， ZHONG Yanlan. //Medical Innovation of China， 2021， 18（23）： -146

[Abstract] Objective： To explore the application of 24 h ambulate blood pressure monitoring in preeclampsia during pregnancy and the rhythm change of blood pressure during pregnancy. Method： A total of 50 patients with preeclampsia during pregnancy from April 2016 to April 2019 were selected as the observation group， another 60 patients with normal pregnancy at the same time were selected as the control group. Both groups were monitored for 24 h ambulate blood pressure monitoring. The blood pressure-related indicators， renal function， perinatal outcome were compared between the two groups， 24 h blood pressure of patients with different severity of eclampsia and were compared. Result： The 24 h SBP， 24 h DBP， dSBP， dDBP， nSBP， nDBP in the observation group were higher than those in the control group， the differences were statistically significant （P<0.05）. The BUN， Scr， and SUA in the observation group were higher than those in the control group， the differences were statistically significant （P<0.05）. 24 h mean blood pressure， daytime mean blood pressure and night mean blood pressure in patients with mild preeclampsia were lower than those in severe preeclampsia， the differences were statistically significant （P<0.05）. The incidence of adverse pregnancy outcomes in the observation group was higher than that in the control group， the difference was statistically significant （P<0.05）. Conclusion： Through 24 h ambulate blood pressure monitoring for patients with preeclampsia during pregnancy， it is possible to fully understand the patient’s blood pressure changes， take timely intervention measures and use 24 h ambulate blood pressure monitoring to understand the effect of their treatment， and provide a basis for reasonable arrangement of treatment and nursing operations， thereby reducing the occurrence of eclampsia ensures the safety of mothers and babies， which is worthy of promotion and application.

[Key words] Preeclampsia during pregnancy 24 h ambulate blood pressure monitoring Rhythm change of blood pressure Renal function

First-author’s address： Ganzhou People’s Hospital， Ganzhou 341000， China

doi：10.3969/j.issn.1674-4985.2021.23.035

子痫前期是妊娠高血压疾病中最为常见的一种，发病率为6%左右，该疾病可威胁到患者本身及胎儿，可导致患者多脏器功能受到损害，并可引起胎儿宫内发育迟缓，使其处于早产、胎盘早剥等危险中，从而导致不良妊娠结局[1]。子痫前期发生的早晚也会对该疾病的发展和预后造成严重影响。对于子痫前期的诊断，以往临床上常采用偶尔监测血压的方法，但容易出现误诊，从而影响疾病的诊断和治疗，随着动态血压监测在临床上的应用，其临床意义已被广大学者认同[2-3]。……