血清Lp-PLa2,Hcy及CysC联合检测在妊娠期高血压诊断中的临床意义

Clinical Significance of Combined Detection of Serum Lp-PLa2,Hcy and CysC for the Diagnosis of Hypertensive Disorder Complicating Pregnancy

目的探讨血清脂蛋白相关磷脂酶a2(Lp-PLa2)、同型半胱氨酸(Hcy)与胱抑素C(CysC)联合检测在妊娠期高血压综合征(HDCP)诊断的临床意义。方法选取2013年1月～2016年5月长安医院就诊的113例妊娠期高血压患者为观察组,分为A,B,C三组(A组为妊娠高血压患者55例、B组为轻度子痫前期患者32例、C组为重度子痫前期患者26例),同时选择该院同期50例正常妊娠者作为对照组,检测血清Lp-PLa2(酶联免疫法)、Hcy(循环酶法)以及CysC(微粒子增强免疫比浊法),对检测结果进行比较分析。结果血清Lp-PLa2,Hcy和CysC检测结果在对照组、观察组A、观察组B及观察组C呈递增性升高,以观察组C升高最明显,与对照组相比观察组血清Lp-PLa2,Hcy和CysC检测结果明显升高,差异有统计学意义(F=8.102,7.231,6.926,均P<0.05);Pearson相关性分析结果显示血清Lp-PLa2,Hcy和CysC检测结果与血压之间存在正相关关系(r=0.71,0.69,0.63,均P<0.05);血清Lp-PLa2,Hcy及CysC三项联合检测异常率高于单项检测异常率,差异有统计学意义(χ~2=6.725,P<0.001);且血清Lp-PLa2,Hcy及Cys单项检测结果异常率随着HDCP病情的加重而升高,差异具有统计学意义(χ~2=9.351,P<0.000)。结论血清Lp-PLa2,Hcy和CysC与妊娠期高血压综合征的发生、发展密切相关,联合检测有利于提高HDCP异常结果的检出率,对HDCP早期诊断及预后判断具有重要临床意义。

Objective To investigate the clinical significance of combined detection of lipoprotein associated serum ph0spho- lipase A2 （Lp-PLa2）,homocysteine （Hcy） and cystatin C （CysC） in the diagnosis of hypertensive disorders complicating pregnancy （HDCP）. Methods From January 2013 to May 2016 in Changan Hospital,selected 113 cases of pregnancy in- duced hypertension patients as the observation group, and were divided into three group A,B and C （group At 55 cases of HDCP patients,group B： 32 cases of mild preeclampsia and group C for patients with severe preeclampsia 26 cases）. At the same period, selected 50 cases of normal college pregnancy as control group, serum Lp-PLa2 （enzyme-linked immunosorbent assay）, Hcy （cyclophorase method） and CysC （particle enhanced turbidimetric method） , the test results were analyzed and compared. Results Serum Lp-PLa2, Hcy and CysC test results in the control group, the observation group A,observation group B and observation group C increased significantly,in the observation group C increased most obviously. Compared with the control group, the serum levels of Lp-PLa2, Hcy and CysC in the observation group were significantly higher,the differ- ence was statistically significant （F： 8.102,7.231 and 6. 926, all P〈0.05）. Pearson correlation analysis showed that there was a positive correlation between serum Lp-PLa2, H cy and CysC and blood pressure （r= 0. 71,0. 69,0. 63, all P〈：0.05）. The abnormal rate of serum Lp-PLa2, Hcy and CysC for three joint detection was higher than that of single detection, and the difference was statistically significant （z = 6. 725 ,P〈0. 001）. The abnormal rate of serum Lp-PLa2, Hey and Cys single test results increased with the exacerbation of HDCP, and the difference was statistically significant （X^2 = 9. 3511P〈0. 000）. Conclusion Serum Lp-PLa2, Hcy,CysC and pregnancy would be closely related to the occurrence and development of hypertension syndrome, so combined detection of HDCP can improve the detection rate of abnormal results,and it has im- portant clinical significance for early diagnosis and prognosis of HDCP.