西藏高原地区重度子痫前期患者临床生化指标异常分析及意义

Analysis and clinical significances of changes of clinical biochemical indexes of patients with severe preeclampsia in Tibet plateau

目的:比较西藏高原地区重度子痫前期患者与正常妊娠孕妇临床生化检测指标的异常变化并分析其临床意义。方法:选择重度子痫前期疾病组患者123例,其中,早发型重度子痫前期疾病组患者38例,晚发型重度子痫前期疾病组患者85例,同期正常妊娠组妇女120例,对比分析各组间的临床生化指标变化。结果:重度子痫前期疾病组与正常妊娠组比较,血清转氨酶(ALT、AST)、胆固醇(Ch)、三酰甘油(TG)、低密度脂蛋白(LDL)、血肌酐(Cre)、尿素氮(BUN)水平均升高,白蛋白(Alb)、高密度脂蛋白(HDL)、钙(Ca2+)水平均降低、差异均有统计学意义(P<0.05);早发型重度子痫前期疾病组较晚发型疾病组相比,ALT、AST、Ch、TG、LDL、Cre、BUN水平均升高,Alb、Ca2+水平均降低、差异均有统计学意义(P<0.05),两组HDL差异无统计学意义(P>0.05)。结论:西藏高原地区孕妇的血肝肾功能、白蛋白、血脂及血钙浓度等几种临床生化指标的异常变化反映了早发型重度子痫前期病情较晚发型者更加严重。临床医师应结合这些生化指标变化情况对重度子痫前期患者病情做到全面而准确的预测、诊断和评估,进而积极采取有效的临床干预措施,有效降低母儿危重病症发生率和死亡率,不断改善西藏高原地区重度子痫前期母儿不良预后。

Objective To compare the changes of clinical biochemical indicators between Tibetan normal pregnant women and patients with severe preeclampsia in plateau region,and to analyze the clinical significance.Method123pregnant women with severe preeclampsia were selected as the disease group.According to the gestational week,the disease group was divided into the early onset preeclampsia group38casese and the late onset preeclampsia group85cases.120normal pregnant women were selected as the control group.All staff were performed on blood biochemical index detection and analyzed the changes of these indexes between different groups.Results The levels of serum transaminases(ALT,AST),creatinine(Cre),blood urea nitrogen(BUN),cholesterol(Ch),triglyceride(TG),low density lipoprotein(LDL)in the disease group was significantly higher and Calcium(Ca2+),albumin(Alb),high density lipoprotein(HDL)was significantly lower than that in the control group,the differences were statistically significant(P<0.05);Compared with the late onset preeclampsia group,ALT,AST,Cre,BUN,Ch,TG,LDL was significantly higher and Ca2+,Alb was lower in the early onset preeclampsia group,the differences were statistically significant(P<0.05);There was no statistical significance in the HDL between the early and late onset preeclampsia groups(P>0.05).Conclusion The abnormal changes of blood biochemical indexes(ALT,AST,Alb,Cre,BUN,TG,Ch,LDL,HDL,Ca2+)in severe preeclampsia patients represent the severer degree of the early onset preeclampsia in Tibet plateau.The clinicians should pay attention to the abnormal changes of these indexes,make a comprehensive prognosis,diagnosis and estimating,take effective measures to improve maternal and infantile prognosis of Tibetan patients with severe preeclampsia in plateau region.