子前期发病类型与血栓前状态的关系

Study on the relationship between prothrombotic state and the onset patterns of preeclampsia

目的探讨子前期发病类型与血栓前状态的关系。方法选择2007年5月至2008年3月在中国医科大学盛京医院产科住院的105例子前期患者为研究对象,检测49例早发型子前期(早发组)、56例晚发型子前期(晚发组)患者及同期正常妊娠妇女52例(对照组)入院时纤维蛋白原(FIB),D-二聚体(DD),总蛋白(TP),白蛋白(A),丙氨酸转氨酶(ALT),天冬氨酸转氨酶(AST),血清肌酐(Scr),血清尿素氮(BUN),24h尿蛋白量(UP)等相关指标。结果(1)早发组与晚发组比较:FIB(g/L)(6.20±1.40对5.50±0.80),DD(μg/L)(454.93±326.72对390.67±123.47),ALT(U/L)(80.22±148.41对18.46±17.91),AST(U/L)(146.90±296.36对23.81±14.022),24hUP(g)(4.22±6.09对1.18±1.83),TP(g/L)(60.07±8.60对55.85±6.01),A(g/L)(32.30±4.23对31.07±3.05)均有升高(P<0.05)。(2)对照组FIB、DD、TP、A、ALT、AST、Scr(μmol/L)、BUN(μmol/L)、24hUP分别为4.27±0.90,378.05±242.25,61.22±5.19,34.49±2.60,8.37±3.08,16.01±3.88,57.01±6.95,3.05±0.82,0,早发组与之比较:FIB,DD,ALT,AST,Scr(67.6±13.57),BUN(4.28±1.66),24h尿蛋白量升高,TP、A均降低(P<0.05)。(3)晚发组与对照组比较:FIB,DD,Scr(71.09±31.85),BUN(4.47±1.61),24hUP升高,TP、A降低(P<0.05)。结论子前期患者都存在着血栓前状态和多脏器功能受损,其中早发型子前期的改变更为显著。

Objective To investigate the relationship between prothrombotic state and the type of preeclampsia. Methods Totally 105 patients with preeclampsia, who were admitted to our hospital between May 2007 and March 2008, were chosen for this study. FIB, DD, TP, A, ALT, AST, Scr, BUN, UP, and other related indicators were measured. In 49 patients with early-onset preeclampsia and 56 patients with late-onset preeclampsia. Results （1） Early-onset group vs normal group ： Coagulation indexes （ FIB, DD） were significantly increased （ P 〈 0. 05 ）, renal function indexes （ Scr, BUN, 24-hour urine protein） were significantly increased （ P 〈 0. 05 ）, liver function indexes were increased in ALT, AST, TP and A （ P 〈 0. 05 ）. （ 2 ） Coagulation indexes （ FIB, DD） were significantly increased （ P 〈 0.05 ）, renal function indexes （ Scr, BUN, 24-hour urine protein） were significant increased （ P 〈 0. 05 ） , and liver function indexes （ TP, A） were decreased （P 〈 0. 05 ）. （3） Early-onset group vs late-onset group： Coagulation indexes （FIB, DD） were significantly increased （ P 〈 0. 05 ）, renal function indexes （ 24-hour urine protein ） were significantly increased （ P 〈 0. 05 ）, liver function indexes were increased in ALT, AST, TP and A （ P 〈 0. 05 ）. Conclusion Pre-thrombosis state and multi-organ dysfunction widely exist in the patients with preeclampsia. The changes of the early-onset preeclampsia are more markable. Therefore, it is important to correct the disturbance of the coagulation system, and strengthen the protection of the maternal organs.