溶血磷脂酸与抗心磷脂抗体联合检测在妊高症患者中的临床意义

Clinical significance of combined detection of LPA and ACA in patients with pregnancy-induced hypertension

目的 探讨溶血磷脂酸（lysophosphatidic acid,LPA）与抗心磷脂抗体（anti-cardiolipin antibody,ACA）联合检测预测妊高症疾病发展及妊娠结局的价值.方法 分别采用生化法、酶联免疫法测定142例妊高症患者（其中妊娠期高血压53例,轻度子痫前期46例,重度子痫前期43例）及正常妊娠晚期孕妇（对照组58例）血浆LPA水平及抗心磷脂抗体阳性率,分析两者在不同程度妊高症患者中的差异及相关性,同时评价其与妊娠预后的关系.结果 妊高症患者血浆LPA水平随病情发展依次升高,且均高于对照组（P＜0.05）;重度妊高症组抗心磷脂抗体阳性率高于其他组（P＜0.05）.重度妊高症患者抗心磷脂抗体阳性组血浆LPA水平明显升高,且发病孕周小,围产儿体重低,新生儿Apgar评分低,与阴性组比较,差异均有统计学意义（P＜0.05或0.01）.结论 妊娠期高血压疾病病情程度与血浆LPA水平相关,病情越重,LPA水平也越高.抗心磷脂抗体与重度妊高症的发病有关.LPA与ACA联合检测可早期预测妊高症的病情程度及妊娠结局,有望成为病情监测及预后判断的指标.

Objective To investigate the value of the combined detection of lysophosphatidic acid （ LPA ） and anti-cardiolipin antibody （ ACA ） for forecasting the development of pregnancy hypertension disease and pregnancy outcome. Methods Euzymelinked immunosorbent assay and biochemical treatment were respectively used to determinate the LPA level in plasma and anticardiolipin antibody positive rate of 142 cases of pregnancy- induced hypertension, including 53 cases of pregnancy-induced hypertension, mild preeclampsia 46 cases, and severe preeclampsia 43 cases, and normal late pregnant women （ control group, 58 cases ） , so to analyse the differences and correlation in patients with different degree pregnancy-induced hypertension and at the same time to evaluate its relationship with pregnancy outcome. Results The plasma LPA levels in patients with pregnancyinduced hypertension syndrome increased successively with the progression of the disease and were higher than that in the control group （ P 〈 0.05 ） ; the anticardiolipin antibody positive rate of severe PIH group was higher than that of other groups （P 〈 0.05 ） . The plasma level of LPA of the patients whose anticardiolipin antibody was positive in severe PIH group increased significantly, and the gestational age was small when onset, weight of perinatal low, and neonatal Apgar score low, which statistically differed from those of the negative group （P 〈 0.05 or 0.01 ） . Conclusions The severity of pregnancy-induced hypertension correlates with plasma LPA level; the more severe the disease becomes, the level of LPA is higher. Anticardiolipin antibody correlates with the pathogenesis of severe PIH. The combined detection of LPA and ACA can predict the severity of pregnancy- induced hypertension syndrome and pregnancy outcome, and it is expected to become the important measure of disease monitoring and prognosis.