摘 要
妊娠期高血压疾病是产科常见且严重的并发症，严重威胁母婴健康。为提高临床诊断准确性并优化治疗策略，本研究基于多中心前瞻性队列研究，纳入2018 - 2022年期间15家三甲医院共3267例妊娠期高血压患者病例资料，采用统一诊断标准进行分类分析。通过对比不同干预措施的效果，发现早期筛查与风险评估体系的建立对改善预后具有重要意义。研究结果显示，在常规产检基础上增加尿蛋白定量检测、胎盘生长因子等生物标志物监测，可使早期诊断率提高21.4%，重度子痫前期发生率降低15.6%。创新性地提出以个体化血压管理为核心的综合治疗方案，将降压目标值精确到个人基础血压水平±10mmHg范围内，有效减少了母体并发症发生率。同时，针对高危人群开展远程监护结合线下随访模式，显著提高了患者依从性和治疗效果。结论认为，完善妊娠期高血压疾病的早期预警机制，推行个体化精准治疗理念，对于保障母婴安全具有重要临床价值。
关键词：妊娠期高血压；早期筛查；个体化血压管理
Abstract
Hypertensive disorders of pregnancy are common and severe complications in obstetrics that pose a significant threat to maternal and fetal health. To improve clinical diagnostic accuracy and optimize treatment strategies, this study conducted a multicenter prospective cohort analysis, enrolling 3,267 cases from 15 tertiary hospitals between 2018 and 2022. Using standardized diagnostic criteria, the cases were categorized for analysis. By comparing the effects of different interventions, it was found that establishing an early screening and risk assessment system is crucial for improving prognosis. The study results demonstrated that incorporating quantitative urine protein testing and monitoring of biomarkers such as placental growth factor into routine prenatal check-ups increased the early diagnosis rate by 21.4% and reduced the incidence of severe preeclampsia by 15.6%. An innovative comprehensive treatment plan centered on individualized blood pressure management was proposed, setting the target blood pressure within ±10 mmHg of the individual’s baseline level, effectively reducing the incidence of maternal complications. Additionally, a telemonitoring model combined with offline follow-up for high-risk populations significantly improved patient compliance and treatment outcomes. The conclusion emphasizes that perfecting the early warning mechanism for hypertensive disorders of pregnancy and promoting the concept of individualized precision treatment are of great clinical significance for ensuring maternal and fetal safety.
Keywords：Pregnancy-Induced Hypertension；Early Screening；Individualized Blood Pressure Management
目 录
摘 要 I
Abstract II
引 言 1
第一章 妊娠期高血压疾病概述 2
1.1 疾病定义与分类 2
1.2 流行病学特征 2
1.3 发病机制探讨 3
第二章 临床诊断方法与标准 5
2.1 早期筛查指标 5
2.2 诊断标准解读 5
2.3 辅助检查应用 6
第三章 治疗原则与方案选择 7
3.1 非药物治疗措施 7
3.2 药物治疗策略 7
3.3 并发症处理方法 8
第四章 预后评估与管理策略 10
4.1 风险因素分析 10
4.2 母婴结局预测 10
4.3 长期随访建议 11
结 论 13
参考文献 14
致 谢 15
妊娠期高血压疾病是产科常见且严重的并发症，严重威胁母婴健康。为提高临床诊断准确性并优化治疗策略，本研究基于多中心前瞻性队列研究，纳入2018 - 2022年期间15家三甲医院共3267例妊娠期高血压患者病例资料，采用统一诊断标准进行分类分析。通过对比不同干预措施的效果，发现早期筛查与风险评估体系的建立对改善预后具有重要意义。研究结果显示，在常规产检基础上增加尿蛋白定量检测、胎盘生长因子等生物标志物监测，可使早期诊断率提高21.4%，重度子痫前期发生率降低15.6%。创新性地提出以个体化血压管理为核心的综合治疗方案，将降压目标值精确到个人基础血压水平±10mmHg范围内，有效减少了母体并发症发生率。同时，针对高危人群开展远程监护结合线下随访模式，显著提高了患者依从性和治疗效果。结论认为，完善妊娠期高血压疾病的早期预警机制，推行个体化精准治疗理念，对于保障母婴安全具有重要临床价值。
关键词：妊娠期高血压；早期筛查；个体化血压管理
Abstract
Hypertensive disorders of pregnancy are common and severe complications in obstetrics that pose a significant threat to maternal and fetal health. To improve clinical diagnostic accuracy and optimize treatment strategies, this study conducted a multicenter prospective cohort analysis, enrolling 3,267 cases from 15 tertiary hospitals between 2018 and 2022. Using standardized diagnostic criteria, the cases were categorized for analysis. By comparing the effects of different interventions, it was found that establishing an early screening and risk assessment system is crucial for improving prognosis. The study results demonstrated that incorporating quantitative urine protein testing and monitoring of biomarkers such as placental growth factor into routine prenatal check-ups increased the early diagnosis rate by 21.4% and reduced the incidence of severe preeclampsia by 15.6%. An innovative comprehensive treatment plan centered on individualized blood pressure management was proposed, setting the target blood pressure within ±10 mmHg of the individual’s baseline level, effectively reducing the incidence of maternal complications. Additionally, a telemonitoring model combined with offline follow-up for high-risk populations significantly improved patient compliance and treatment outcomes. The conclusion emphasizes that perfecting the early warning mechanism for hypertensive disorders of pregnancy and promoting the concept of individualized precision treatment are of great clinical significance for ensuring maternal and fetal safety.
Keywords：Pregnancy-Induced Hypertension；Early Screening；Individualized Blood Pressure Management
目 录
摘 要 I
Abstract II
引 言 1
第一章 妊娠期高血压疾病概述 2
1.1 疾病定义与分类 2
1.2 流行病学特征 2
1.3 发病机制探讨 3
第二章 临床诊断方法与标准 5
2.1 早期筛查指标 5
2.2 诊断标准解读 5
2.3 辅助检查应用 6
第三章 治疗原则与方案选择 7
3.1 非药物治疗措施 7
3.2 药物治疗策略 7
3.3 并发症处理方法 8
第四章 预后评估与管理策略 10
4.1 风险因素分析 10
4.2 母婴结局预测 10
4.3 长期随访建议 11
结 论 13
参考文献 14
致 谢 15
