论文部分内容阅读
目的:研究重度子痫前期患者体内D-二聚体水平与妊娠结局的相关性。方法:选择余杭区妇幼保健院2009年9月至2011年8月重度子痫前期的病人80例使用全自动血凝仪SysmexCA-500采用酶联免疫法(ELISA)检测所有患者体内D-二聚体的含量,46例(57.5%)检测结果D-二聚体水平≤200μg/l患者视为阴性组,34例(42.5%)检测结果>200μg/l为阳性组,阳性组患者每日口服阿司匹林肠溶片100mg,必要时予每日皮下注射低分子肝素钠针0.3ml。结果:所有患者中剖宫产例数68例(85%),阴道产12例(15%)。其中阳性组实施剖宫产所占比例96.8%(31),阴道产1.6%(1例);阴性组中实施剖宫产所占比例54.5%(37),阴道产91.6%(11例);阳性组中婴儿出生后呼吸评分<7分25例(78.1%),阴性组21例(45.5%);两组患者妊娠结局具有显著差异性,阳性组剖宫产率明显高于阴性组(χ2=12.414,P<0.01),新生儿出生评分显著低于阴性组(t=3.241,P<0.01)且产妇的并发症较高(χ2=4.234,P<0.01)。结论:重度子痫前期者内皮细胞异常出现早,容易导致凝血亢进、纤维溶解亢进,D-二聚体明显升高;可以通过测定D-二聚体及时发现血管内皮损伤,对于临床预防及早期干预治疗具有重要指导意义。
Objective: To study the correlation between D-dimer level and pregnancy outcome in patients with severe preeclampsia. Methods: Eighty patients with severe preeclampsia from September 2009 to August 2011 in Yuhang District Maternal and Child Health Hospital were enrolled in this study. All patients were tested for D-dimer by enzyme-linked immunosorbent assay (ELISA) using the automatic coagulation analyzer SysmexCA-500 46 cases (57.5%) test results D-dimer levels ≤ 200μg / l patients were considered negative, 34 (42.5%) test results> 200μg / l for the positive group, the positive group of patients daily oral Aspirin enteric-coated tablets 100mg, if necessary, daily subcutaneous injection of low molecular weight heparin needle 0.3ml. RESULTS: Cesarean section was 68 (85%) and vaginal (12) (15%) in all patients. In the positive group, the rate of cesarean section was 96.8% (31) and that of the vagina was 1.6% (1 case). In the negative group, the rate of cesarean section was 54.5% (37) and the vagina was 91.6% (11 cases) In the positive group, the infant’s respiratory score after birth was <7 points and 25 cases (78.1%), and 21 cases (45.5%) were negative. The pregnancy outcome was significantly different between the two groups, and the positive rate of cesarean section was significantly higher than that of the negative group = 12.414, P <0.01). Neonatal birth scores were significantly lower than those in the negative group (t = 3.241, P <0.01) and maternal complications were higher (χ2 = 4.234, P <0.01). Conclusions: In severe preeclampsia, endothelial cell abnormalities appear early and easily result in hyperthyroidism, hyperfibrinolysis and increased D-dimer. Vascular endothelial injury can be detected in time by D-dimer, and clinical prevention and early stage Intervention treatment has important guiding significance.