| 摘要 |
【摘要】 目的 探讨妊娠高血压患者妊娠结局及产后抑郁发生情况，并分析产后抑郁的相关因素。方法 收集2021年2月至2023年12月本院收治的92例妊娠高血压患者临床资料，并开展回顾性分析。记录妊娠结局，并采用爱丁堡产后抑郁量表（Edinburgh Postnatal Depression Scale,EPDS）评估孕产妇产后抑郁发生情况。分析发生产后抑郁的相关因素，建立预测模型。结果 92例患者发生不良妊娠结局14例，发生率为15.22%，发生产后抑郁16例，发生率为17.39%。Logistic多因素模型分析显示，高血压家族史（β=0.623，95%CI=1.227-2.835，P=0.004）、不良妊娠结局（β=1.309，95%CI=1.426-9.611，P=0.007）、血清超敏C反应蛋白（hypersensitive C-reactive protein，hs-CRP）（β=0.933，95%CI=1.607-4.024，P＜0.001）及血清同型半胱氨酸（homocysteine,Hcy）（β=0.900，95%CI=1.157-5.226，P=0.019）是产后抑郁的高危因素，血清5-羟色胺（5-hydroxytryptamine, 5-HT）（β=-0.368，95%CI=0.512-0.935，P=0.017）与血清雌二醇（Esaadiol,E2）（β=-0.222，95%CI=0.672-0.955，P=0.013）是产后抑郁的保护因素。根据多因素分析结果建立预测模型Y=0.623×（X2）+1.309×（X3）+0.933×（X5）+0.900×（X6）-0.368×（X7）-0.222×（X8），ROC分析结果显示该模型判断产后抑郁的AUC为0.853（SE=0.051，95%CI=0.752-0.953，P＜0.001），敏感度为0.917，特异度为0.690。结论 妊娠高血压患者多存在产后抑郁风险，其发生与高血压家族史、不良妊娠结局及血清hs-CRP、5-HT、E2及Hcy水平相关。
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| Abstract |
[Abstract] Objective To explore the pregnancy outcomes and postpartum depression in patients with gestational hypertension, and analyze the relevant factors of postpartum depression.Methods The clinical dataes of 92 patients with gestational hypertension admitted in our hospital from February 2021 to December 2023 were collected, and conduct a retrospective analysis.The pregnancy outcomes was recorded and the incidence of postpartum depression in pregnant women evaluated by the edinburgh postpartum depression scale (EPDS).The relevant factors of postpartum depression was analyzed and establish a predictive model.Results 92 patients had 14 adverse pregnancy outcomes,the incidence rate was 15.22%,there were 16 cases of postpartum depression,the incidence rate was 17.39%.The Logistic multivariate model analysis shows that the family history of hypertension（β=0.623, 95%CI=1.227-2.835,P=0.004), adverse pregnancy outcomes（β=1.309, 95%CI=1.426-9.611,P=0.007), serum hs-CRP（β=0.933, 95%CI=1.607-4.024, P<0.001) and serum Hcy（ β=0.900, 95%CI=1.157-5.226, P=0.019) were high-risk factor for postpartum depression,the serum 5-HT（β=-0.368, 95%CI=0.512-0.935,P=0.017) and serum E2（β=-0.222, 95%CI=0.672-0.955, P=0.013) were protective factor for postpartum depression.The prediction model Y=0.623×(X2)+1.309×(X3)+0.933×(X5)+0.900×(X6) -0.368×(X7) -0.222×(X8) was established,which based on the results of multiple factor analysis.The ROC analysis results showed that the AUC of the model for predicting postpartum depression was 0.853 (SE=0.051, 95%CI=0.752-0.953, P<0.001),the sensitivity was 0.917 and the specificity was 0.690.Conclusion Pregnancy induced hypertension patients are at risk of postpartum depression, which are associated with family history of hypertension, adverse pregnancy outcomes, and serum hs CRP, 5-HT, E2, and Hcy levels.
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