子痫前期患者血清D-二聚体与细胞间黏附分子-1、可溶性血管内皮生长因子受体1、血脂的相关性

Correlation of Serum D-dimer Levels with Intercellular Adhesion Molecule-1, Soluble Vascular Endothelial Growth Factor Receptor 1, Blood Lipid Levels in Preeclampsia Patients

目的探讨子痫前期(pre-eclampsia,PE)患者血清D-二聚体(D-Dimer,D-D)水平及其与细胞间黏附分子-1(intercellular adhesion molecule-1,ICAM-1)、可溶性血管内皮生长因子受体1(soluble fms-like tyrosine kinase-1,sFlt-1)、血脂水平的相关性。方法选取2017年5月至2019年5月山东省德州市人民医院诊治的160例PE患者为研究对象,按照《妊娠期高血压疾病诊治指南(2012版)》中关于PE病情严重程度分类标准分为PE重度组(83例)和PE轻度组(77例),并选取同期80例正常妊娠孕妇作为对照组。比较各组的D-D、ICAM-1、sFlt-1、血脂水平[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)],并分析D-D与ICAM-1、sFlt-1、血脂水平的相关性。结果各组研究对象D-D、ICAM-1、sFlt-1水平差异均有统计学意义(P均<0.05);D-D、ICAM-1、sFlt-1水平PE重度组高于PE轻度组和对照组,PE轻度组高于对照组(P均<0.05)。各组收缩压(SBP)、舒张压(DBP)、24 h蛋白尿水平差异均有统计学意义(P均<0.05);SBP、DBP、24 h蛋白尿水平PE重度组高于PE轻度组和对照组,PE轻度组高于对照组(P均<0.05)。各组TC、TG、HDL-C、LDL-C水平差异均有统计学意义(P均<0.05);TC、TG、LDL-C水平PE重度组高于PE轻度组和对照组,PE重度组的HDL-C水平低于PE轻度组和对照组,PE轻度组的TC、TG、LDL-C水平高于对照组,PE轻度组的HDL-C水平低于对照组(P均<0.05)。经Pearson分析,D-D与ICAM-1、sFlt-1、TC、TG、LDL-C、SBP、DBP、24 h蛋白尿水平呈正相关,D-D与HDL-C水平呈负相关(P均<0.01)。结论PE患者的血清D-D水平增高,D-D水平可辅助评估患者的病情严重程度,且与ICAM-1、sFlt-1、血脂水平具有相关性。

Objective To investigate the serum level of D-Dimer(D-D)and its intercellular adhesion molecule-1(ICAM-1),soluble fms-like tyrosine kinase-1(sFlt-1)and blood lipid levels in pre-eclampsia(PE)patients.Methods Totally 160 cases of PE patients treated in our hospital from May 2017 to May 2019 were selected as the research objects.They were divided into PE according to the classification criteria of PE severity in the Guidelines for the Diagnosis and Treatment of Hypertension During Pregnancy(2012 Edition).Severe group(83 cases)and PE mild group(77 cases),and 80 normal pregnant women during the same period were selected as the control group.D-D,ICAM-1,sFlt-1,blood lipid levels[total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)]were compared,and the correlations between D-D and ICAM-1,sFlt-1,and blood lipid levels were analyzed.Results The levels of D-D,ICAM-1 and s Flt-1 in each group were statistically significant(P all<0.05);the levels of D-D,ICAM-1 and sFlt-1 in PE severe group were significantly higher than those in PE mild group and the control group.The levels of D-D,ICAM-1 and sFlt-1 in the mild group were significantly higher than those in the control group,and the differences were statistically significant(P all<0.05).The systolic blood pressure,diastolic blood pressure,and 24 h proteinuria levels were statistically significant in each group(P all<0.05);the systolic blood pressure,diastolic blood pressure,and 24 h proteinuria levels in the severe PE group were significantly higher than those in the PE mild group and the control group.The systolic blood pressure,diastolic blood pressure,and 24 h proteinuria level in the PE mild group were significantly higher than those in the control group,and the differences were statistically significant(P all<0.05).The levels of TC,TG,HDL-C,and LDL-C in all groups were statistically significant(P all<0.05);the levels of TC,TG,and LDL-C in the PE severe group were significantly higher than those in the PE mild group and the control group.The HDL-C level in the PE severe group was significantly lower than that in the PE mild group and the control group.The TC,TG,and LDL-C levels in the PE mild group were significantly higher than those in the control group.The HDL-C level in the PE mild group was significantly lower.In the control group,the differences were statistically significant(P<0.05).According to Pearson analysis,D-D was positively correlated with ICAM-1,sFlt-1,TC,TG,LDL-C,systolic blood pressure,diastolic blood pressure,24 h proteinuria level,and D-D was negatively correlated with HDL-C level(P all<0.01).Conclusion Serum D-D levels are highly expressed in PE patients.D-D levels can assist in assessing the severity of the patient's condition,and are correlated with ICAM-1,sFlt-1,and blood lipid levels.