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目的探讨检测D-二聚体(D-D)、脂联素(APN)对于妊娠期高血压疾病孕妇血压及病情严重程度的预测价值,为妊娠期高血压疾病防治提供参考,改善患者预后。方法选取2014年10月-2016年10月该院妊娠期高血压疾病患者820例为观察组,进一步分为甲组,妊娠期高血压患者344例;乙组,轻度子痫前期患者262例;丙组,重度子痫前期患者214例。选取同期入院健康体检的正常妊娠晚期孕妇800例为对照组。抽取研究对象血液,检测其血浆D-D、APN水平,检测各组血压情况。结果对照组血清APN水平明显高于观察组、乙组、丙组(均P=0.00);与甲组比较,差异无统计学意义(P=0.56)。甲乙丙三组血清APN水平逐渐下降,差异有统计学意义(P<0.05)。对照组血浆D-D水平明显低于观察组、甲组、乙组、丙组(均P=0.00);甲乙丙三组血浆D-D水平呈下降趋势(P<0.05)。观察组各组血浆D-D水平与其收缩压、舒张压呈正相关性(丙组r=0.785、0.861;甲组r=0.466、0.581;乙组r=0.562、0.675,均P=0.00)。观察组各组血清APN水平与其收缩压、舒张压呈负相关性(丙组r=-0.639、-0.711;乙组r=-0.528、-0.612;甲组r=-0.476、-0.563,均P=0.00);对照组血浆D-D与APN间无相关性;甲乙丙组中,患者血浆D-D水平、APN水平呈负相关性(丙组r=-0.681;甲组r=-0.472;乙组r=-0.569,均P=0.00)。结论检测妊娠期高血压疾病患者血浆D-D和APN水平可作为患者血压水平及病情严重程度的重要指标,患者血清APN水平下降及D-D水平升高可提示妊娠期高血压疾病患者发病及病情发展,因此检测血浆D-D和APN水平可为妊娠期高血压疾病防治提供参考。
Objective To investigate the predictive value of D-D and APN for the blood pressure and severity of pregnancy-induced hypertension in pregnant women and to provide reference for the prevention and treatment of hypertensive disorders in pregnancy and to improve the prognosis of patients. Methods From October 2014 to October 2016, 820 cases of hypertensive disorder complicating pregnancy were selected as the observation group, further divided into group A and 344 cases of hypertensive disorder during pregnancy. Group B, 262 patients with mild preeclampsia ; Group C, severe preeclampsia in 214 cases. Select the normal hospitalized during the same period of normal pregnancy, 800 pregnant women as control group. Blood samples were drawn from the subjects, plasma D-D and APN levels were measured, and blood pressure was measured in each group. Results The level of serum APN in control group was significantly higher than that in observation group, group B and group C (all P = 0.00). There was no significant difference between group A and group A (P = 0.56). Serum APN levels in the three groups were gradually decreased, the difference was statistically significant (P <0.05). The plasma D-D level in the control group was significantly lower than that in the observation group, group A, group B and group C (all P = 0.00). The plasma D-D level in the group B and C was declining (P <0.05). The plasma D-D level in each group was positively correlated with systolic and diastolic blood pressure (group r = 0.785,0.861; group A: r = 0.466,0.581; group B: r = 0.562,0.675, all P = 0.00). The levels of serum APN in each group were negatively correlated with systolic and diastolic blood pressure (group r = -0.639, -0.711; group r = -0.528, -0.612; group r = -0.476, -0.563, all P = 0.00). There was no correlation between plasma DD and APN in the control group. There was a negative correlation between plasma DD level and APN level in the A and B groups (r = -0.681 in group C; r = -0.472 in group A; r = -0.569, all P = 0.00). Conclusion Detection of plasma DD and APN levels in patients with hypertensive disorders of pregnancy can be used as an important index of the patient’s blood pressure and severity of illness. The decrease of serum APN level and the increase of DD level may indicate the onset and progression of patients with hypertensive disorder complicating pregnancy. Detection of plasma levels of DD and APN can provide reference for the prevention and treatment of hypertensive disorders in pregnancy.