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目的探讨妊娠合并肺动脉高压对患者妊娠结局的影响。方法妊娠合并肺动脉高压患者90例,根据肺动脉收缩压水平分为轻度组(收缩压30~50mm Hg)、中度组(收缩压>50~80mm Hg)、重度组(收缩压>80mm Hg)各30例,比较3组心功能分级与妊娠结局。结果重度组心功能Ⅲ~Ⅳ级者比例(86.7%)高于轻度组(40.0%)和中度组(43.3%)(P<0.05),轻度组与中度组比较差异无统计学意义(P>0.05);中、重度组引产率(3.3%、3.3%)、足月分娩率(56.7%、50.0%)低于轻度组(13.4%、85.0%),早产率(40.0%、46.7%)高于轻度组(3.3%)(P<0.05);中、重度组小于胎龄儿出生率(33.3%、43.3%)、窒息发生率(13.4%、20.0%)、围生儿病死率(3.3%、6.7%)高于轻度组(6.7%、6.7%、0)(P<0.05)。结论妊娠合并肺动脉高压患者肺动脉压力越高,心功能状况以及妊娠结局越差。
Objective To investigate the effect of pregnancy complicated with pulmonary hypertension on pregnancy outcome. Methods Ninety patients with pregnancy complicated with pulmonary hypertension were divided into mild group (systolic pressure 30-50 mm Hg), moderate group (systolic pressure> 50-80 mm Hg) and severe group (systolic pressure> 80mm Hg) according to pulmonary systolic pressure 30 cases in each group. The cardiac function grading and pregnancy outcome were compared among the three groups. Results The percentage of heart function Ⅲ ~ Ⅳ in severe group was significantly higher than that in mild group (40.0%) and moderate group (43.3%) (P <0.05), but there was no significant difference between mild group and moderate group The rates of term delivery (56.7%, 50.0%) were lower than those of mild group (13.4%, 85.0%), premature delivery rate was 40.0% (P> 0.05) , 46.7% respectively) were higher than those in mild group (3.3%) (P <0.05); moderate and severe cases were less than those of gestational age (33.3%, 43.3%), asphyxia (13.4%, 20.0% Mortality (3.3%, 6.7%) was higher than in the mild group (6.7%, 6.7%, 0) (P <0.05). Conclusions The higher the pulmonary pressure in patients with pregnancy complicated with pulmonary hypertension, the worse the cardiac function and pregnancy outcome.