子痫前期与血栓前状态关系的临床分析

Relationship between preeclampsia and prethrombotic state: a clinial analysis

目的探讨子痫前期与血栓前状态的关系。方法选择2009年11月—2010年11月92例子痫前期患者为研究对象,其中40例为早发型子痫前期(早发组),52例为晚发型子痫前期(晚发组);分别选择同期正常妊娠妇女各52例入选对照1、2组。检测各组凝血指标纤维蛋白原(FIB)、D-二聚体,肝功能指标总蛋白(TP)、白蛋白(A)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST),肾功能指标血清肌酐(SCr)、血清尿素(BUN)、24h尿蛋白量(24hUP)。结果早发组的FIB、D-二聚体均显著高于对照1组(P值均<0.05),晚发组均显著高于对照2组(P值均<0.05),早发组的FIB、D-二聚体显著高于晚发组(P值均<0.05)。早发组的SCr、BUN、24hUP均显著高于对照1组(P值均<0.05),晚发组均显著高于对照2组(P值均<0.05),早发组与晚发组间SCr、BUN的差异均无统计学意义(P值均>0.05),早发组的24hUP显著高于晚发组(P<0.05)。早发组的ALT、AST均显著高于对照1组和晚发组(P值均<0.05),TP、A均显著低于对照组(P值均<0.05);晚发组的TP、A均显著低于对照2组(P值均<0.05),ALT、AST的差异均无统计学意义(P值均>0.05);早发组的TP、A有晚发组的趋势,但两组间差异无统计学意义(P值均>0.05)。结论子痫前期患者存在血栓前状态和多脏器功能受损,其中早发型子痫前期的改变更为显著。

Objective To explore the relationship between preeclampsia and prethrombotic state. Methods From November 2009 to November 2010, 92 inhospital patients with preeclampsia were enrolled in this study and divided into early onset group （n=40） and late onset group （n=52）. Meanwhile, 104 normal pregnancy women were selected into two control groups （n=52）. Coagulation index （fibrinogen , D-dimer）, liver functional parameter （total protein , albumin, alanine aminotransferase , aspartate aminotransferase ）, and renal functional parameter （serum creatinine , serum urea , 24-hour urinary protein [24hUP]） were measured. Results FIB and D-dimer in the early onset group were significantly higher than those in the control 1 group and late onset group （P0.05）. FIB and D-dimer in the late onset group were significantly higher than those in the control 2 group （P0.05）. SCr, BUN and 24hUP in the early onset group were significantly higher than those in the control 1 group （P0.05）. SCr, BUN and 24hUP in the late onset group were significantly higher than those in the control 2 group （P0.05）. There were no statistical differences in SCr and BUN between the early and late onset groups （P0.05）. But 24hUP in the early onset group was significantly higher than the late onset group （P0.05）. ALT and AST in the early onset group were significantly higher than those in the control 1 group, but TP and albumin in the early onset group were significantly lower than those in the control 1 group （P0.05）. TP and albumin in the late onset group were significantly lower than those in the control 2 group （P0.05）, but there were no statistical differences in ALT and AST between the two groups （P0.05）. TP and albumin in the early onset group were a little lower than those in the late onset group, but there were no statistical differences between the two groups （P0.05）. ALT and AST in the early onset group were significantly higher than those in the late onset group （P0.05）. Conclusion Prethrombotic state and multiple organ dysfunction exist in preeclampsia patients. These changes are more significant in early onset preeclampsia.