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NEJM:产前高血压是否需要严格控制?

2015-02-06 MedSci MedSci原创

《新英格兰医学杂志》近期发表了一项研究成果:产前严格控制高血压与非严格控制相比并不改善死亡或严重并发症风险。 实验随机选取了987名怀孕女性,其中大多数产前患有高血压。严格控制血压组的妊娠损伤或需要48小时以上新生儿高级护理的比例为30.7%,非严格控制血压的比例为31.4%。两组严重高血压比例分别为27.5%和40.6%。 受试者未用降压药时舒张压为90-105 mmHg或用药后舒张压为8

《新英格兰医学杂志》近期发表了一项研究成果:产前严格控制高血压与非严格控制相比并不改善死亡或严重并发症风险。

实验随机选取了987名怀孕女性,其中大多数产前患有高血压。严格控制血压组的妊娠损伤或需要48小时以上新生儿高级护理的比例为30.7%,非严格控制血压的比例为31.4%。两组严重高血压比例分别为27.5%和40.6%。

受试者未用降压药时舒张压为90-105 mmHg或用药后舒张压为85-105 mmHg;妊娠期的14周~34周之间,且是单胎妊娠。受试者被随机分配至非严格控制组(目标舒张压:100-104 mmHg)和严格控制组(目标舒张压:81-85 mmHg)。研究者希望这些受试者通过治疗以保持血压在目标值(100 mmHg或85 mmHg)±5 mmHg范围内浮动。结果显示,非严格控制组与严格控制组间治疗依从性相似(分别是74.1%和73.4%)。整个实验中,非严格控制组女性的血压水平高于严格控制组,收缩压高 5.8 mmHg(95% CI 4.5-7.0,P<0.001),舒张压高4.6 mmHg(95% CI 3.7-5.4,P<0.001)。产前非严格控制组有73.4%女性服用降压药,严格控制组为92.6%,产后比例分别降至65.5%和 78.3%(P<0.001)。

研究还对产妇的健康状况进行了6周的跟踪观察,对新生儿健康情况进行了28周跟踪观察,或至出院。主要结果是妊娠损伤或48小时以上高等新生儿护理。次要结果是严重的产妇和新生儿并发症。

本文是MedSci编译,欢迎转载,转载请注明出处,非常感谢!


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  1. [GetPortalCommentsPageByObjectIdResponse(id=16044, encodeId=f12d16044fc, content=good, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cce01615276, createdName=Johnny1989, createdTime=Mon Feb 16 15:31:00 CST 2015, time=2015-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15886, encodeId=480015886fb, content=小编评论亮了, beContent=null, objectType=article, channel=null, level=null, likeNumber=158, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c68e1614119, createdName=windmilL1989, createdTime=Mon Feb 16 14:30:00 CST 2015, time=2015-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15358, encodeId=5db915358f3, content=yeah , Good !, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=101.81.71.**, createdTime=Thu Feb 12 10:45:00 CST 2015, time=2015-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15290, encodeId=0c09152900a, content=好的,明白的, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Sun Feb 08 14:45:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15289, encodeId=5da615289d7, content=好的,明白的, beContent=null, objectType=article, channel=null, level=null, likeNumber=150, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Sun Feb 08 14:43:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502453, encodeId=2d0f150245339, content=<a href='/topic/show?id=ef4b2441971' target=_blank style='color:#2F92EE;'>#产前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24419, encryptionId=ef4b2441971, topicName=产前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b49a9545081, createdName=qilu_qi, createdTime=Sun Feb 08 01:27:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15215, encodeId=0b6e15215b6, content=good, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=MedSci客户端网友, createdTime=Fri Feb 06 14:02:00 CST 2015, time=2015-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15213, encodeId=451f1521316, content=right, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=MedSci客户端网友, createdTime=Fri Feb 06 10:46:00 CST 2015, time=2015-02-06, status=1, ipAttribution=)]
    2015-02-16 Johnny1989

    good

    0

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    2015-02-16 windmilL1989

    小编评论亮了

    0

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    2015-02-12 101.81.71.**

    yeah , Good !

    0

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    2015-02-08 午夜星河

    好的,明白的

    0

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    2015-02-08 午夜星河

    好的,明白的

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=16044, encodeId=f12d16044fc, content=good, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cce01615276, createdName=Johnny1989, createdTime=Mon Feb 16 15:31:00 CST 2015, time=2015-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15886, encodeId=480015886fb, content=小编评论亮了, beContent=null, objectType=article, channel=null, level=null, likeNumber=158, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c68e1614119, createdName=windmilL1989, createdTime=Mon Feb 16 14:30:00 CST 2015, time=2015-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15358, encodeId=5db915358f3, content=yeah , Good !, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=101.81.71.**, createdTime=Thu Feb 12 10:45:00 CST 2015, time=2015-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15290, encodeId=0c09152900a, content=好的,明白的, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Sun Feb 08 14:45:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15289, encodeId=5da615289d7, content=好的,明白的, beContent=null, objectType=article, channel=null, level=null, likeNumber=150, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Sun Feb 08 14:43:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502453, encodeId=2d0f150245339, content=<a href='/topic/show?id=ef4b2441971' target=_blank style='color:#2F92EE;'>#产前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24419, encryptionId=ef4b2441971, topicName=产前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b49a9545081, createdName=qilu_qi, createdTime=Sun Feb 08 01:27:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15215, encodeId=0b6e15215b6, content=good, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=MedSci客户端网友, createdTime=Fri Feb 06 14:02:00 CST 2015, time=2015-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15213, encodeId=451f1521316, content=right, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=MedSci客户端网友, createdTime=Fri Feb 06 10:46:00 CST 2015, time=2015-02-06, status=1, ipAttribution=)]
    2015-02-08 qilu_qi
  7. [GetPortalCommentsPageByObjectIdResponse(id=16044, encodeId=f12d16044fc, content=good, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cce01615276, createdName=Johnny1989, createdTime=Mon Feb 16 15:31:00 CST 2015, time=2015-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15886, encodeId=480015886fb, content=小编评论亮了, beContent=null, objectType=article, channel=null, level=null, likeNumber=158, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c68e1614119, createdName=windmilL1989, createdTime=Mon Feb 16 14:30:00 CST 2015, time=2015-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15358, encodeId=5db915358f3, content=yeah , Good !, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=101.81.71.**, createdTime=Thu Feb 12 10:45:00 CST 2015, time=2015-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15290, encodeId=0c09152900a, content=好的,明白的, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Sun Feb 08 14:45:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15289, encodeId=5da615289d7, content=好的,明白的, beContent=null, objectType=article, channel=null, level=null, likeNumber=150, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Sun Feb 08 14:43:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502453, encodeId=2d0f150245339, content=<a href='/topic/show?id=ef4b2441971' target=_blank style='color:#2F92EE;'>#产前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24419, encryptionId=ef4b2441971, topicName=产前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b49a9545081, createdName=qilu_qi, createdTime=Sun Feb 08 01:27:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15215, encodeId=0b6e15215b6, content=good, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=MedSci客户端网友, createdTime=Fri Feb 06 14:02:00 CST 2015, time=2015-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15213, encodeId=451f1521316, content=right, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=MedSci客户端网友, createdTime=Fri Feb 06 10:46:00 CST 2015, time=2015-02-06, status=1, ipAttribution=)]
    2015-02-06 MedSci客户端网友

    good

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=16044, encodeId=f12d16044fc, content=good, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cce01615276, createdName=Johnny1989, createdTime=Mon Feb 16 15:31:00 CST 2015, time=2015-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15886, encodeId=480015886fb, content=小编评论亮了, beContent=null, objectType=article, channel=null, level=null, likeNumber=158, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c68e1614119, createdName=windmilL1989, createdTime=Mon Feb 16 14:30:00 CST 2015, time=2015-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15358, encodeId=5db915358f3, content=yeah , Good !, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=101.81.71.**, createdTime=Thu Feb 12 10:45:00 CST 2015, time=2015-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15290, encodeId=0c09152900a, content=好的,明白的, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Sun Feb 08 14:45:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15289, encodeId=5da615289d7, content=好的,明白的, beContent=null, objectType=article, channel=null, level=null, likeNumber=150, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200609/ef6a57dbe7f1489dad7446b7c5217858/d5e4fe65996c4446a029b0f5d056abb1.jpg, createdBy=6b011518214, createdName=午夜星河, createdTime=Sun Feb 08 14:43:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502453, encodeId=2d0f150245339, content=<a href='/topic/show?id=ef4b2441971' target=_blank style='color:#2F92EE;'>#产前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24419, encryptionId=ef4b2441971, topicName=产前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b49a9545081, createdName=qilu_qi, createdTime=Sun Feb 08 01:27:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15215, encodeId=0b6e15215b6, content=good, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=MedSci客户端网友, createdTime=Fri Feb 06 14:02:00 CST 2015, time=2015-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=15213, encodeId=451f1521316, content=right, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=MedSci客户端网友, createdTime=Fri Feb 06 10:46:00 CST 2015, time=2015-02-06, status=1, ipAttribution=)]
    2015-02-06 MedSci客户端网友

    right

    0

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