探讨妊娠高血压综合征患者血浆总同型半胱氨酸水平检测的临床意义

Clinical significance investigation of plasma total homocysteine level detection in patients with pregnancy induced hypertension

目的探讨妊娠高血压综合征(妊高症)患者血浆总同型半胱氨酸(tHcy)水平检测的临床意义。方法选取70例妊高症患者作为妊高症组,另选取70例健康孕晚期孕妇作为对照组。妊高症组采用综合治疗,合并高同型半胱氨酸(Hcy)血症患者给予叶酸、甲钴胺治疗。比较妊高症组与对照组血浆tHcy浓度及高Hcy血症发生率、不同严重程度妊高症患者血浆tHcy浓度及高Hcy血症发生率、妊高症患者治疗前后血浆tHcy浓度及高Hcy血症发生率。结果妊高症组血浆tHcy浓度(11.15±2.97)μmol/L高于对照组的(5.18±1.64)μmol/L,高Hcy血症发生率38.57%高于对照组的5.71%,差异有统计学意义(P<0.05)。妊娠高血压患者血浆tHcy浓度低于轻度子痫前期和重度子娴前期患者,轻度子痫前期患者血浆tHcy浓度低于重度子娴前期患者,差异有统计学意义(P<0.05)。妊娠高血压患者高Hcy血症发生率19.35%低于重度子娴前期患者的62.5%,差异有统计学意义(P<0.05),妊娠高血压患者高Hcy血症发生率与轻度子痫前期比较,差异无统计学意义(P>0.05),轻度子痫前期患者与重度子娴前期患者高Hcy血症发生率比较差异无统计学意义(P>0.05)。妊高症患者治疗后tHcy浓度及高Hcy血症发生率均低于治疗前,差异有统计学意义(P<0.05)。结论妊高症是影响母婴健康的疾病,需早期发现、早期干预治疗。妊高症患者血浆tHcy浓度明显升高,高Hcy血症发生率明显增加,且随着病情加重,血浆tHcy浓度上升更加明显,经治疗后明显下降,可见密切监测患者血浆tHcy浓度对妊高症临床诊治有重要意义。

Objective To investigate the clinical significance of plasma total homocysteine（tHcy） level detection in patients with pregnancy induced hypertension（PIH）. Methods A total of 70 PIH patients were selected as PIH group, and 70 healthy pregnant women in the same period were selected as the control group. The PIH group received comprehensive treatment, and patients with hyperhomocysteinemia were treated with Folic Acid and Mecobalamin. The plasma tHcy concentration and incidence of hyperHcy between the PIH group and control group, plasma tHcy concentration and incidence of hyperHcy in PIH patients with different severity, plasma tHcy concentration and incidence of hyperHcy in PIH patients before and after treatment were compared. Results The plasma tHcy concentration of the PIH group was（11.15±2.97） μmol/L, which was significantly higher than（5.18±1.64） μmol/L of the control group, the incidence of hyperHcy in the PIH group was 38.57%, which was significantly higher than 5.71% in the control group, the differences were statistically significant（P〈0.05）. The plasma tHcy concentration of PIH pregnant women were significantly lower than those of mild preeclampsia patients and severe preeclampsia patients, the plasma tHcy concentration of mild preeclampsia patients was significantly lower than that of severe preeclampsia patients, the differences were statistically significant（P〈0.05）. The incidence of hyperHcy in PIH pregnant women was 19.35%, which was significantly lower than 62.5% in the severe preeclampsia patients, the difference was statistically significant（P〈0.05）. There was no significant difference in the incidence of hyperHcy between PIH pregnant women and mild preeclampsia patients（P〈0.05）. And there was no significant difference in the incidence of hyperHcy between mild preeclampsia patients and severe preeclampsia patients（P〉0.05）. The plasma tHcy concentration and incidence of hyperHcy in PIH patients after treatment were significantly lower than those before treatment, the differences were statistically significant（P〈0.05）. Conclusion PIH is a disease that affects maternal and infant health. Early detection and early intervention are necessary. The plasma tHcy concentration in PIH patients is significantly increased, and the incidence of hyperHcy is significantly increased. And with the aggravation of the disease, plasma tHcy concentration increased more significantly, after treatment decreased significantly, it can be seen that close monitoring of plasma tHcy concentration of PIH patients has important significance in clinical diagnosis and treatment.