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投稿时间:2022-07-09 网络发布日期:2022-12-20
投稿时间:2022-07-09 网络发布日期:2022-12-20
中文摘要: 目的 观察心电图提示的心脏顺钟向转位的妊娠期女性不良孕产结局发生情况,并分析其临床意义。方法 采用回顾性研究方法,纳入2016年1月1日至2018年12月31日就诊于广东省妇幼保健院行心电图检查且自建册至27+6周的妊娠期女性12827例。将纳入者分为伴有或不伴有心脏顺钟向转位两组,分别计算妊娠期女性心脏顺钟向转位与发生死胎、子痫前期、血栓性疾病的比值比。通过logistic模型纳入人口学特征(年龄、BMI、孕次、产次)和妊娠期合并症(妊娠期高血压、多胎妊娠、妊娠期糖尿病、孕前糖尿病合并妊娠)共8个协变量,对单变量分析结果有统计学意义的结局进行多变量校正。结果 12 827例接受心电图检查的妊娠中早期女性,其中发生心脏顺钟向转位孕妇134例,无心脏转位孕妇12 693例。存在心脏顺钟向转位者血栓性疾病发生率2.24%(3/134)较无心脏顺钟向转位者的0.07%(9/12693)更高,差异有统计学意义(P<0.01)。经多变量校正后,心脏顺钟向转位的妊娠期女性发生血栓性疾病的风险仍然显著升高(OR=28.824,95%CI:7.248~114.618,P<0.01)。结论 尽管心电图提示的心脏顺钟向转位在妊娠期阳性率较低,但是妊娠期心电图发现心脏顺钟向转位可能与血栓性疾病有一定关系,提示应当对血栓性疾病的相关风险进一步筛查。
Abstract:Objective To observe the incidence of adverse pregnancy outcome in pregnant women with clockwise cardiac rotation indicated by electrocardiogram(ECG) and analyze its clinical significance. Methods A retrospective study was performed on 12 827 pregnant women who were admitted to Guangdong Province Maternity and Child Health Hospital for ECG examination from January 1st, 2016 to December 31st, 2018(from card establishment to 27+6 weeks of gestation). The participants were dichotomized two groups according to the presence and absence of clockwise rotation in ECG. The associations of clockwise rotation with stillbirth, preeclampsia and thrombotic disease were analyzed. The significant covariates(including age, body mass index, gravidity, parity, gestational hypertension, multiple pregnancy, gestational diabetes mellitus and pregestational diabetes mellitus) using univariate analysis were adjusted by multivariate logistic analysis. Results Out of the pregnant women in middle and early pregnancy, there were 134 pregnant women with clockwise cardiac rotation and 12 693 pregnant women without cardiac transposition. The incidence of thrombotic disease in patients with clockwise rotation was significantly higher than that in patients without clockwise rotation [2.24%(3/134) vs 0.07%(9/12 693), P<0.01]. After multivariable adjustment, the risk of thrombotic disease in pregnant women with clockwise rotation remained significantly higher(OR=28.824, 95%CI: 7.248-114.618, P<0.01). Conclusion Although the prevalence of ECG-indicated clockwise rotation is low among pregnant women during pregnancy, it may be related to thrombotic disease, suggesting that further screening should be conducted for the related risks of thrombotic disease.
keywords: Pregnancy Electrocardiography Clockwise rotation Pregnant outcome Thrombotic disease Preeclampsia Stillbirth
文章编号: 中图分类号: 文献标志码:A
基金项目:
Author Name | Affiliation |
HE Min*, LYU Li-juan | *Functional Department, Ezhou Central Hospital, Ezhou, Hubei 436000, China |
引用文本:
何敏,吕莉娟.妊娠心电图显示的顺钟向转位与妊娠不良结局的关系[J].中国临床研究,2022,35(12):1676-1679.
何敏,吕莉娟.妊娠心电图显示的顺钟向转位与妊娠不良结局的关系[J].中国临床研究,2022,35(12):1676-1679.