妊娠期高血压综合征患者血浆血栓调节蛋白及D-二聚体的变化及意义

Changes of plasma TM and D-dimer in patients with pregnancy-induced hypertension syndrome and its clinical significance

目的探讨妊娠期高血压综合征（妊高征）患者血浆血栓调节蛋白、D-二聚体水平变化及意义。方法应用ELISA法对30例正常妊娠孕妇、46例妊高征孕妇（其中轻度16例，中度11例，重度19例）血浆血栓调节蛋白、D-二聚体进行检测。结果（1）血栓调节蛋白：正常妊娠组为（2．526±1．682）μg／L，轻度妊高征组为（2．725±1．321）μg／L，中度妊高征组为（4．165±1．632）μg／L，重度妊高征组为（4．862±1．265）μg／L；正常妊娠组与轻度妊高征组TM差异无统计学意义（P〉0．05），与中度、重度妊高征组比较差异有统计学意义（P〈0．05）；（2）D-二聚体：正常妊娠组为（0．38±0．16）μg／L，轻度妊高征组为（0．58±0．20）μg／L，中度妊高征组为（0．71±0．23）μg／L，重度妊高征组为（0．96±0．18）μg／L；正常妊娠组与妊高征组比较差异有统计学意义（P〈0．05）。结论随着妊高征病情的加重，血浆血栓调节蛋白、D-二聚体水平也逐渐升高，D-二聚体可作为妊高征孕妇早期弥散性血管内凝血（DIC）的监测指标，血栓调节蛋白可作为反映妊高征严重程度的有效指标。应用以上指标，不但有助于早期诊断，并且可以判断DIC发展状况。

Objective To investigate the changes of plasma TM and D-dimer in patients with pregnancy-induced hypertension syndrome and its clinical significance. Methods 30 normal pregnant women and 46 patients with pregnancy-induced hypertension syndrome （PIH） （16 cases of mild PIH, 11 cases of moderate PIH and 19 cases of severe PIH） were enrolled in the investigation. ELISA was applied to detecting plasma thrombomodulin （TM）and D-dimer （DD）. Results （1）TM： The average levels of plasma TM in normal pregnant women, mild PIH patients, moderate PIH patients and severe PIH patients were （2. 526±1. 682）μg/L, （2. 725±1. 321）μg/L, （4. 165±1. 632）μg/L and （4. 862±1. 265）μg/L respectively. There was no statistical difference of plasma TM level between normal pregnant women group and mild PIH patients group （P〉0.05）. The average level of plasma TM in moderate PIH and severe PIH group were significantly higher than that of normal pregnant women group （P〈0.05）. （2） D-dimer： The average levels of plasma D-dimer in normal pregnant women, mild PIH patients, moderate PIH patients and severe PIH patients were （0.38±0. 16） mg/L, （0.58±0. 20） mg/L, （0.71±0.23） mg/L and （0.96±0.18） mg/L respectively. There was statistical difference of plasma DD level between normal pregnant women group and PIH groups （P〈0.05）. Conclusion The levels of plasma TM and D-dimer were gradually rising with progress of the illness. D-dimer can be used as a marker for monitoring disseminated intravascular coagulation （DIC）, and TM as an available index for monitoring state of PIH. The measurement of plasma TM and D-dimer is helpful to early diagnosis and severity estimation of DIC.