妊娠高血压综合征患者的尿微量白蛋白和血流变学指标的变化及其临床意义

Changes and clinical significance of microalbuminuria and hemorheology in patients with pregnancy induced hypertension syndrome

目的探讨尿微量白蛋白(mALB)和血流变学指标在妊娠高血压综合征患者中的变化和临床意义。方法选择2017年3月至2020年3月于四会市人民医院接受产检的100例妊娠期高血压综合征患者作为观察组,其中妊娠期高血压53例、轻度子痫前期32例、重度子痫前期15例,并选择同期产检结果均正常的孕妇50例作为对照组。比较两组孕妇的一般资料、mALB和血液流变学指标的变化,并比较观察组不同病情程度患者mALB和血液流变学指标的变化。结果观察组患者的收缩压(SBP)、舒张压(DBP)分别为(151.36±6.03)mmHg、(95.14±6.17)mmHg,明显高于对照组的(120.23±6.81)mmHg、(76.86±5.13)mm Hg,差异均有统计学意义(P<0.05);观察组和对照组患者的mALB[(61.45±4.04)mg/L vs(6.40±1.53)mg/L]、全血高切黏度[(4.70±0.34)mPa·s vs(3.98±0.21)mPa·s]、全血低切黏度[(12.83±2.15)mPa·s vs(8.71±0.56)m Pa·s]、高切还原黏度[(13.62±2.03)mPa·s vs(7.30±1.53)mPa·s]、低切还原黏度[(18.40±1.93)mPa·s vs(15.20±1.64)mPa·s]、血浆黏度[(1.87±0.21)mPa·s vs(1.25±0.26)mPa·s]、红细胞聚集指数[(5.31±0.28)vs(4.50±0.37)]、红细胞变形指数[(1.35±0.30)vs(0.70±0.12)]、红细胞电泳时间[(18.73±2.50)vs(13.91±2.41)s]、红细胞压积[(40.45±2.30)%vs(40.45±2.30)%]、纤维蛋白原[(5.89±0.38)g/L vs(3.50±0.43)g/L]比较,观察组明显高于对照组,差异均有统计学意义(P<0.05);观察组不同病情程度患者中,重度子痫前期组患者的mALB、全血高切黏度、全血低切黏度、高切还原黏度、低切还原黏度、血浆黏度、红细胞聚集指数、红细胞变形指数、红细胞电泳时间、红细胞压积、纤维蛋白原均明显高于妊娠期高血压组和轻度子痫前期组,轻度子痫前期组上述指标均明显高于妊娠期高血压组,差异均有统计学意义(P<0.05)。结论妊娠期高血压疾病综合征患者的mALB表达较高,血液流变学指标存在明显异常,且随着疾病的加重异常程度更明显,临床上应重视对上述指标的检测。

Objective To study the changes and clinical significance of microalbumin(mALB)and hemorheology in patients with pregnancy induced hypertension syndrome.Methods A total of 100 patients with pregnancy induced hypertension syndrome,who admitted to Sihui People’s Hospital from March 2017 to March 2020,were selected as the observation group.Among them,there were 53 cases of gestational hypertension,32 cases of mild preeclampsia and 15 cases of severe preeclampsia,and 50 pregnant women with normal results of prenatal examination were selected as the control group.The general information,the changes of m ALB and hemorheology indexes were compared between two groups pregnant woman,and the changes of mAlb and hemorheology indexes in the observation group with different degrees of illness were compared.Results The systolic blood pressure(SBP)and diastolic blood pressure(DBP)in the observation group were(151.36±6.03)mmHg and(95.14±6.17)mmHg,which were significantly higher than corresponding(120.23±6.81)mm Hg and(76.86±5.13)mmHg in the control group(P<0.05);mALB,whole blood high shear viscosity,whole blood low shear viscosity,high shear reduction viscosity,low shear reduction viscosity,plasma viscosity,erythrocyte aggregation index,erythrocyte deformation index,erythrocyte electrophoresis time,hematocrit and fibrinogen in the observation group were(61.45±4.04)mg/L,(4.70±0.34)mPa·s,(12.83±2.15)mPa·s,(13.62±2.03)m Pa·s,(18.40±1.93)m Pa·s,(1.87±0.21)m Pa·s,5.31±0.28,1.35±0.30,(18.73±2.50)s,(47.54±3.60)%,(5.89±0.38)g/L,which were significantly higher than corresponding(6.40±1.53)mg/L,(3.98±0.21)m Pa·s,(8.71±0.56)m Pa·s,(7.30±1.53)mpa·s,(15.20±1.64)mPa·s,(1.25±0.26)m Pa·s,4.50±0.37,0.70±0.12,(13.91±2.41)s,(40.45±2.30)%,(3.50±0.43)g/L of the control group(all P<0.05).In the observation group patients with different degrees of illness,mALB,whole blood high shear viscosity,whole blood low shear viscosity,high shear reduced viscosity,low shear reduced viscosity,plasma viscosity,erythrocyte aggregation index,erythrocyte deformation index,erythrocyte electrophoresis time,hematocrit and fibrinogen in severe preeclampsia group patients were significantly higher than those in the gestational hypertension group and mild preeclampsia group,and the above indexes in the mild preeclampsia group were significantly higher than gestational hypertension group,with difference were statistically significant differences(all P<0.05).Conclusion In patients with hypertensive induced hypertension syndrome,m Alb expression is higher,the hemorheology indexes are significantly abnormal,and with the aggravation of the disease,the abnormal degree is more obvious.