妊娠期高血压疾病与血小板降低及子宫动脉血流异常的相关性

The correlation of hypertensive disease in pregnancy with platelet decrease and uterine artery blood flow abnormalities

目的分析妊娠期高血压疾病严重程度与血小板(PLT)降低及子宫动脉异常症状的关系,探讨血小板降低与子宫动脉异常之间的相关性。方法选取入住我院的妊娠高血压重度妊娠高血压患者、轻度妊娠高血压患者和正常妊娠患者,其中正常妊娠患者为对照组,对3组患者的血小板参数、子宫动脉多普勒参数进行比较,研究血小板与子宫动脉异常的关系。结果轻度妊娠高血压组PLT为(138±23)×109/L,重度妊娠高血压组的为(132±28)×109/L,显著低于正常妊娠组的(154±19)×109/L;轻度妊娠高血压组平均血小板体积(MPV)为(10.20±0.23)fL,重度妊娠高血压组的为(11.20±0.15)fL,显著高于正常妊娠组的(9.15±0.19)fL;轻度妊娠高血压组血小板分布宽度(PDW)为(29.2±1.5)%,重度妊娠高血压组的为(31.2±2.1)%,显著高于正常妊娠组的(26.1±1.7)%,差异均有统计学意义(P<0.05);轻度妊娠高血压组与重度妊娠高血压组患者的胎儿脐动脉收缩压与舒张压比值(S/D)、阻力指数和搏动指数均高于正常妊娠组,差异有统计学意义(P<0.05);重度妊娠高血压组患者的血小板计数与子宫动脉S/D值成反比(r=-0.78),而轻度妊娠高血压血小板计数与子宫动脉S/D值成正比(r=0.8),差异有统计学意义(P<0.05)。结论患者的血小板降低与子宫动脉血流异常均可以反映妊娠高血压的病情程度,在临床诊断中具有一定的价值。

Objective To study the relationship between the severity of pregnancy induced hypertension and platelet decrease and uterine artery abnormality,and to investigate the correlation between the decrease of platelet and uterine artery abnormality. Methods The patients with pregnancy induced hypertension in our hospital were selected including severe pregnancy induced hypertension, mild gestational hypertension and normal pregnancy. The normal pregnancy was as control group. We compared the platelet parameters and uterine artery Doppler parameters of three groups of patients to study the relationship between platelet and uterine artery abnormality. Results The PLT of mild gestational hypertension group and severe pregnancy induced hypertension group was 138±23 （×10^9/L） and 132±28 （×10^9/L）, respectively, and they were significantly lower than 154±19 （× 10^9/L） of normal pregnancy group; the MPV of mild gestational hypertension group and severe pregnancy induced hypertension group was （10.20±0.23）fI. and （11.20±0.15）fL, respectively, and they were significantly higher than （9.15 ± 0. 19）fL of normal pregnancy group; The PDW of mild gestational hypertension group and severe pregnancy induced hypertension group was 29.2 2± 1.5 （0/00） and 31.2 ± 2.1 （%）, and they were significantly higher than 26.1± 1.7 （%） of normal pregnancy group; the differences were statistically significant（P〈0.05） ; S/D, resistance index and pulsatility index in patients of mild pregnancy hypertension group and severe pregnancy induced hypertension group were significantly higher than those in normal pregnancy group, and the difference was statistically significant（P〈 0.05）. In severe pregnancy induced hypertension group, the platelet count was inversely proportional to uterine artery S/D value （r= -0. 78）; while in mild gestational hypertension group , platelet count was proportional to uterine artery S/D （r=0.8） ,the difference was statistically significant（P〈0.05）. Conclusion Platelet decrease and uterine artery blood flow abnormalities can reflect the severity of pregnancy-induced hypertension, and has some value in clinical diagnosis.