妊娠高血压患者血脂指标、凝血指标及红细胞压积的改变及对妊娠结局的影响

Changes of blood lipid indexes, coagulation indexes and hematocrit in patients with pregnancy-induced hypertension and their influence on pregnancy outcome

目的观察妊娠高血压患者血脂指标、凝血指标及红细胞压积的改变并分析其对妊娠结局的影响。方法选取2018年12月至2020年4月我科收治的妊娠高血压患者185例,根据病情严重程度将其分为妊娠高血压组75例、子痫前期组65例和重度子痫前期组45例;另择取同期在我科产检的90例健康妊娠者作为对照组。比较四组患者的血脂指标、凝血指标、红细胞压积及妊娠结局。结果妊娠高血压各组患者的CHOL、TG、LDL-C水平均高于对照组,差异有统计学意义(P<0.05),HDL-C水平均低于对照组,差异有统计学意义(P<0.05);妊娠高血压各组患者的PT、APTT均短于对照组,差异有统计学意义(P<0.05),FIB、HCT水平均高于对照组,差异有统计学意义(P<0.05);四组孕产妇早产、胎盘早剥及胎儿生长受限的发生率比较,差异有统计学意义(P<0.05),低体重儿、新生儿窒息及胎儿窘迫的发生率比较,差异无统计学意义(P>0.05);重度子痫前期组的早产、胎盘早剥的发生率高于其他三组,差异有统计学意义(P<0.05),新生儿窒息、胎儿生长受限的发生率高于对照组,差异有统计学意义(P<0.05)。结论妊娠高血压患者会出现明显的血脂、凝血指标及红细胞压积的改变,并会对妊娠结局产生不良影响。

Objective To observe the changes of blood lipid indexes,coagulation indexes,and hematocrit in patients with pregnancy-induced hypertension and analyze their influence on pregnancy outcome.Methods A total of 185 patients with pregnancy-induced hypertension admitted to our department from December 2018 to April 2020 were selected and divided into 75 patients with pregnancy-induced hypertension,65 patients with preeclampsia,and 45 patients with severe preeclampsia according to the severity of the condition.Ninety healthy pregnant women who were undergoing obstetrics in our department during the same period were selected as the control group.The blood lipid indexes,coagulation indexes,hematocrit,and pregnancy outcome of the four groups were compared.Results The levels of CHOL,TG,and LDL-C of the patients with pregnancy-induced hypertension were higher than those in the control group,with significant difference(P<0.05),and the levels of HDL-C were lower than those in the control group,with significant difference(P<0.05).The PT and APTT in pregnancy hypertension groups were shorter than those in the control group,with significant difference(P<0.05),and the levels of FIB and HCT were higher than those in the control group,with significant difference(P<0.05).There were statistical differences in the incidence of premature delivery,placental abruption,and fetal growth restriction among the four groups(P<0.05).There was no significant difference in the incidence of low birth weight infants,neonatal asphyxia,and fetal distress(P>0.05).The incidence of premature delivery and placental abruption in the severe preeclampsia group was higher than that in the other three groups,with significant difference(P<0.05),the incidence of neonatal asphyxia and fetal growth restriction in the severe preeclampsia group was higher than that in the control group,with significant difference(P<0.05).Conclusion Patients with pregnancy-induced hypertension will have obvious changes in blood lipids,coagulation indicators,and hematocrit,which will adversely affect the outcome of pregnancy.