不同类型重度子痫前期血小板参数变化的研究

A study on changes of platelet parameters in patients with different types of severe preeclampsia

目的探讨不同类型的重度子痫前期患者血小板参数的变化规律及其临床意义。方法将早发型重度子痫前期93例、晚发型重度子痫前期126例作为研究对象,对两组孕妇从妊娠12+1～16周起,每4周1次的血小板计数(platelet count,PLT)、血小板平均体积(mean platelet volume,MPV)、血小板分布宽度(platelet distributing width,PDW)、血小板压积(plateletcrit,PCT)进行对比分析,并与作为对照组的200例正常孕妇相比较。结果①早发型重度子痫前期患者PLT自孕24+1～28周起低于正常对照组及晚发型组患者,晚发型组患者自孕28+1～32周起PLT低于正常对照组孕妇,差异有统计学意义(P<0.05);②早发型重度子痫前期患者在PLT发生变化前4周即出现MVP及PDW高于正常对照组及晚发型组患者,晚发型组患者自孕24+1～28周起MPV、PDW高于正常对照组孕妇,差异有统计学意义(P<0.05)。③早发型重度子痫前期患者自孕28+1～32周起PCT低于正常对照组孕妇,差异有统计学意义(P<0.05)。晚发型组患者PCT与对照组孕妇相比差异无统计学意义。结论早发型重度子痫前期患者较晚发型患者血小板减少更为严重,连续监测血小板参数对于子痫前期的预测、治疗、病情的监测,都有重要的意义。

Objective To explore the changes of platelet parameters in patient with different types of severe pre-eclampsia and its clinical significance. Methods Patients with early onset severe preeclampsia（n= 93） and late-onset severe preeclampsia （n=126） were selected as study group, and normal pregnant women （n=200） as control group. Platelet count （PLT）, mean platelet volume （MPV）, platelet distribution width （PDW） and plateletcrit （PCT） were monitored every 4 weeks from 12＋1~16 weeks.Results ① In early- onset severe preeclampsia group, the level of PLT was significantly lower than that in the control group and the late-onset severe preeclampsia group from 24＋1 ~ 28 weeks （P0.05）; In late-onset severe preeclampsia group, the level of PLT was significantly lower than that in the control group from 28＋1~32 weeks.（P0.05）;② In early onset severe preeclampsia group, significant increasing MPV and PDW were detected to precede the changes of PLT by 4 weeks. In late-onset severe preeclampsia group, the level of MVP and PDW was higher than that in the control group from 28＋1~32 weeks （P0.05）; ③In early onset severe preeclampsia group, the level of PCT was significantly lower than the control group from 28＋1~32 weeks （P0.05）. No significant difference was found in PCT between the late-onset severe preeclampsia patients and the normal pregnant women.Conclusions The disorders of platelet may be more severe in early onset severe preeclampsia than that in late onset preeclampsia. Continuous monitoring of platelet parameters in patient with severe preeclampsia is valuable to evaluation the prognosis and treatment of the disease.