甲襞微循环及胱抑素C联合检测在子痫前期治疗中的临床意义

Changes and Significance of Nail Microcirculation and Cystatin C Measurment in the Treatment of Patients with Pre-eclampsia

目的研究在子痫前期治疗中检测甲襞微循环及胱抑素C(CC)的变化及意义。方法选择子痫前期患者100例,随机分为50例硝酸甘油治疗作为观察组,50例硫酸镁治疗作为对照组。分别测定治疗前后血清CC浓度,甲襞微循环的变化,脐动脉收缩期与舒张期比值(S/D)及阻力指数,血压和24h尿蛋白。结果(1)两组血清CC值及24h尿蛋白治疗后均降低,治疗前后差异有显著性(P<0.01)。(2)观察组治疗后甲襞微循环及血压有显著性变化(P<0.05)而对照组则无明显变化;(3)两组治疗前后脐动脉收缩期与舒张期比值(S/D)及阻力指数差异均有显著性(P<0.05)。结论(1)硝酸甘油能够改善妊娠高血压疾病患者的微循环状态及肾功能,降低血压及胎儿胎盘阻力。(2)硝酸甘油是治疗妊娠高血压疾病的良好方法,甲襞微循环与CC检测可作为子痫前期患者治疗的重要监测指标,为在产科领域广泛应用提供了理论依据。

Objective To study the changes and significance of serum cystatin C and nail microcirculation in the treatment of patients with pre-eclampsia. Methods 100 pre-eclampsia women were divided into magnesium sulfate group and nitroglyce group. Their serum level of CC, umbilical placental artery S/D, resistant ratio index（RI）, blood pressure, 24 hour urine protein were determined. The results were analyzed by SPSS statistical package. Resulls Serum level of CC and 24 hour urine protein assay, umbilical placental artery S/D and resistant ratio index（RI） in each group of pregnancy were significantly lower than those before medication（ P 〈0.01 ）. （2）Blood pressure after medication was significantly lower than that before medication （ P 〈 0.05） in nitroglyce group , but there were no differences in magnesium sulfate group. （3） placental artery S/D and resistant ratio index（RI） in each group of pregnancy were significantly lower than those before medication（ P 〈 0.05）. Conclusion 1. Nitroglyce can reduce fetal umbilical placental vascular resistance and blood pressure. 2. Serum cystatin C and nail microeireulation are important survey guide lines. This experiment provides theoretical basis for nitroglyce to be widely used in obstetrics.