血清Hcy水平与HDCP的相关性及其在发病机制中的作用

Correlation between change of serum homocysteine level and hypertensive disorder complicating pregnancy and its role in pathogenesis

目的探讨血清同型半胱氨酸(Hcy)水平的变化与妊娠期高血压疾病(HDCP)的相关性及在HDCP发病机制中的作用。方法选取2017年1至5月佛山市妇幼保健院产科收治的HDCP患者124例入组研究组,筛选同期健康妊娠妇女124例入组参照组,检测两组Hcy、低密度脂蛋白(ox-LDL)、超敏C反应蛋白(hsCRP)、D-二聚体(D-D)水平,并进行Logistic回归分析。结果研究组Hcy(20.23±1.05)μmol/L、ox-LDL(589.4±134.6)μg/L、hsCRP(25.7±4.2)mg/L及D-D(0.71±0.24)mg/L均明显高于参照组(t值分别为7.582、11.343、12.557、12.352,均P<0.01);HDCP重度患者Hcy(26.25±1.16)μmol/L、ox-LDL(783.6±164.3)μg/L、hsCRP(26.38±6.3)mg/L及D-D(0.89±0.24)mg/L均明显高于中、轻度患者(t值分别为25.64、28.75、20.34、19.87,均P<0.01);经Logistic回归分析,Hcy、ox-LDL、hsCRP及D-D均与HDCP存在明显相关性(β值分别为1.062、0.927、1.103、1.104,均P<0.05)。结论 Hcy、ox-LDL、hsCRP及D-D是与HDCP相关的敏感指标,通过对这些指标水平进行检测,能够有效预测妊娠期高血压疾病的发生及发展;而Hcy水平是引发HDCP形成与发展的重要机制之一。

Objective To investigate the correlation between change of serum homocysteine （Hcy） level and hypertensive disorder complicating pregnancy （HDCP） and its role in HDCP pathogenesis. Methods A total of 124 HDCP patients treated in Department of Obstetrics of Foshan Women and Children Hospital during January to May 2017 were selected into study group, while 124 healthy pregnant women in the same period were selected into control group. The levels of Hcy, low density lipoprotein （ox-LDL）, hypersensitivity C-reactive protein （hsCRP）, D-Dimer （D-D） were detected and Logistic regression analysis was performed. Results In the study group, the levels ofHcy（20.23±1.05）μmol/L,ox-LDL（589.4±134.6）μg/L,hsCRP（25.7±4.2）mg/L and D-D（0.71±0.24）mg/L were significantly higher than those in the control group （t value was 7.582, 11.343, 12.557 and 12.352, respectively, all P〈0.01）. The levels of Hcy （26.25±1.16umol/L）, ox-LDL （783.6±164.3ug/L）, hsCRP （26.38±6.3mg/L） and D-D （0.89±0.24mg/L） of severe HDCP patients were significantly higher than those of mild and moderate HDCP patients （t value was 25.64, 28.75, 20.34 and 19.87, respectively, all P 〈0.01）. According to the Logistic regression analysis, the levels of Hcy, ox-LDL, hsCRP and D-D were significantly correlated with HDCP （β value was 1.062, 0.927, 1.103 and 1.104, respectively, all P〈0.05）. Conclusion Hcy, ox-LDL, hsCRP and D-D are sensitive indicators associated with HDCP. Through detecting the levels of these indicators, the HDCP occurrence and development can be predicted effectively. Meanwhile, Hcy level is one of the important mechanisms that triggers HDCP formation and development.