目的探究拉贝洛尔联合低分子肝素对早发型重度子痫前期孕妇凝血功能及血压影响。方法选取2021年1月至2022年7月济南市第一人民医院收治的80例早发型重度子痫前期患者作为研究对象,随机分为A组与B组,每组40例。A组给予拉贝洛尔治疗,B组...目的探究拉贝洛尔联合低分子肝素对早发型重度子痫前期孕妇凝血功能及血压影响。方法选取2021年1月至2022年7月济南市第一人民医院收治的80例早发型重度子痫前期患者作为研究对象,随机分为A组与B组,每组40例。A组给予拉贝洛尔治疗,B组给予拉贝洛尔联合低分子肝素治疗。比较两组治疗前后凝血功能指标、血压、血脂水平、母婴结局、新生儿Apgar评分及不良反应发生情况。结果治疗后,B组凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)均长于A组,新生儿5、10 min Apgar评分均高于A组,纤维蛋白原(FIB)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平及不良新生儿结局、不良妊娠结局发生率均低于A组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论拉贝洛尔联合低分子肝素治疗早发型重度子痫前期,可改善患者凝血功能、血脂及血压水平,改善母婴结局,且安全性较高。展开更多
Background Early onset severe preeclampsia is a specific type of severe preeclampsia, which causes high morbidity and mortality of both mothers and fetus. This study aimed to investigate the clinical definition, featu...Background Early onset severe preeclampsia is a specific type of severe preeclampsia, which causes high morbidity and mortality of both mothers and fetus. This study aimed to investigate the clinical definition, features, treatment, outcome and risk factors of early onset severe preeclampsia in Chinese women. Methods Four hundred and thirteen women with severe preeclampsia from June 2006 to June 2009 were divided into three groups according to the gestational age at the onset of preeclampsia as follows： group A （less than 32 weeks, 73 cases）, group B ,（between 32 and 34 weeks, 71 cases）, and group C （greater than 34 weeks, 269 cases）. The demographic characteristics of the subjects, complications, delivery modes and outcome of pregnancy were analyzed retrospectively. Results The systolic blood pressure at admission and the incidence of severe complications were significantly lower in group C than those in groups A and B, prolonged gestational weeks and days of hospitalization were significantly shorter in group C than those in groups A and B. Liver and kidney dysfunction, pleural and peritoneal effusion, placental abruption and postpartum hemorrhage were more likely to occur in group A compared with the other two groups. Twenty-four-hour urine protein levels at admission, intrauterine fetal death and days of hospitalization were risk factors that affected complications of severe preeclampsia. Gestational week at admission and delivery week were also risk factors that affected perinatal outcome. Conclusions Early onset severe preeclampsia should be defined as occurring before 34 weeks, and it is featured by more maternal complications and a worse perinatal prognosis compared with that defined as occurring after 34 weeks. Independent risk factors should be used to tailor the optimized individual treatment plan, to balance both maternal and neonatal safety.展开更多
目的探讨早发型子痫前期(early onset pre-eclampsia,EOSP)患者血清内皮细胞特异性分子-1(endothelial cell specific molecule-1,ESM1)及低密度脂蛋白受体相关蛋白-1(low-density lipoprotein receptor-related protein-1,LRP1)水平及...目的探讨早发型子痫前期(early onset pre-eclampsia,EOSP)患者血清内皮细胞特异性分子-1(endothelial cell specific molecule-1,ESM1)及低密度脂蛋白受体相关蛋白-1(low-density lipoprotein receptor-related protein-1,LRP1)水平及与病情严重程度的相关性。方法选取2019年2月~2021年2月盐城市妇幼保健院218例早发型子痫前期患者为研究对象(病例组),根据病情分为轻度组(n=117)和重度组(n=101),以同期健康体检的80例健康孕妇为对照组。比较各组血清ESM1和LRP1水平。采用多因素Logistic回归分析早发型子痫前期病情严重程度的影响因素。绘制受试者工作曲线分析血清ESM1和LRP1对早发型重度子痫前期的诊断价值。结果病例组血清ESM1(323.05±45.17 mmol/L),LRP1(12.25±0.97μg/ml)水平高于对照组(195.20±31.67 mmol/L,6.41±0.84μg/ml),差异具有统计学意义(t=23.291,47.677,均P<0.05)。重度组患者血清ESM1(672.44±83.61 pg/ml),血清LRP1(14.52±1.05μg/ml)、舒张压(113.17±12.24mmHg)、收缩压(165.19±16.63mmHg)、24h尿蛋白量(2.63±0.45g/24h)、血肌酐(74.47±20.82μmol/L)、血尿素氮(4.32±0.78mmol/L)、血尿酸(339.65±50.13μmol/L)高于轻度组(551.74±72.20 pg/ml,9.63±0.89μg/ml,92.41±9.29mmHg,147.25±14.66mmHg,1.42±0.33g/24h,69.64±15.07μmol/L,3.95±0.91mmol/L,303.82±41.71μmol/L),新生儿体质量低于轻度组(2.73±0.62 kg vs 3.20±0.62 kg),差异具有统计学意义(t=1.980~37.978,均P<0.05)。病例组患者血清ESM1及LRP1水平与舒张压、收缩压、24h尿蛋白定量、血肌酐、血尿素氮及血尿酸呈正相关(r=0.413~0.515,均P<0.05),与胎儿体质量呈负相关(r=-0.563,-0.604,均P<0.05)。高血清ESM1水平(OR=1.217,95%CI:1.036~1.429)和高血清LRP1水平(OR=1.486,95%CI:1.056~2.090)是影响早发型重度子痫前期发生的独立危险因素。血清ESM1联合LRP1诊断早发型重度子痫前期的曲线下面积(area under the curve,AUC)0.884(0.853~0.916)大于ESM1(AUC=0.749,95%CI:0.705~0.792)和LRP1(AUC=0.760,95%CI:0.712~0.807)单独诊断(Z=6.752,4.297,均P<0.05)。结论早发型子痫前期患者血清ESM1和LRP1水平升高,二者均与早发型子痫前期疾病严重程度有关,联合检测能提高早发型重度子痫前期的诊断效能。展开更多
文摘目的探究拉贝洛尔联合低分子肝素对早发型重度子痫前期孕妇凝血功能及血压影响。方法选取2021年1月至2022年7月济南市第一人民医院收治的80例早发型重度子痫前期患者作为研究对象,随机分为A组与B组,每组40例。A组给予拉贝洛尔治疗,B组给予拉贝洛尔联合低分子肝素治疗。比较两组治疗前后凝血功能指标、血压、血脂水平、母婴结局、新生儿Apgar评分及不良反应发生情况。结果治疗后,B组凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)均长于A组,新生儿5、10 min Apgar评分均高于A组,纤维蛋白原(FIB)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平及不良新生儿结局、不良妊娠结局发生率均低于A组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论拉贝洛尔联合低分子肝素治疗早发型重度子痫前期,可改善患者凝血功能、血脂及血压水平,改善母婴结局,且安全性较高。
文摘Background Early onset severe preeclampsia is a specific type of severe preeclampsia, which causes high morbidity and mortality of both mothers and fetus. This study aimed to investigate the clinical definition, features, treatment, outcome and risk factors of early onset severe preeclampsia in Chinese women. Methods Four hundred and thirteen women with severe preeclampsia from June 2006 to June 2009 were divided into three groups according to the gestational age at the onset of preeclampsia as follows： group A （less than 32 weeks, 73 cases）, group B ,（between 32 and 34 weeks, 71 cases）, and group C （greater than 34 weeks, 269 cases）. The demographic characteristics of the subjects, complications, delivery modes and outcome of pregnancy were analyzed retrospectively. Results The systolic blood pressure at admission and the incidence of severe complications were significantly lower in group C than those in groups A and B, prolonged gestational weeks and days of hospitalization were significantly shorter in group C than those in groups A and B. Liver and kidney dysfunction, pleural and peritoneal effusion, placental abruption and postpartum hemorrhage were more likely to occur in group A compared with the other two groups. Twenty-four-hour urine protein levels at admission, intrauterine fetal death and days of hospitalization were risk factors that affected complications of severe preeclampsia. Gestational week at admission and delivery week were also risk factors that affected perinatal outcome. Conclusions Early onset severe preeclampsia should be defined as occurring before 34 weeks, and it is featured by more maternal complications and a worse perinatal prognosis compared with that defined as occurring after 34 weeks. Independent risk factors should be used to tailor the optimized individual treatment plan, to balance both maternal and neonatal safety.
文摘目的探讨早发型子痫前期(early onset pre-eclampsia,EOSP)患者血清内皮细胞特异性分子-1(endothelial cell specific molecule-1,ESM1)及低密度脂蛋白受体相关蛋白-1(low-density lipoprotein receptor-related protein-1,LRP1)水平及与病情严重程度的相关性。方法选取2019年2月~2021年2月盐城市妇幼保健院218例早发型子痫前期患者为研究对象(病例组),根据病情分为轻度组(n=117)和重度组(n=101),以同期健康体检的80例健康孕妇为对照组。比较各组血清ESM1和LRP1水平。采用多因素Logistic回归分析早发型子痫前期病情严重程度的影响因素。绘制受试者工作曲线分析血清ESM1和LRP1对早发型重度子痫前期的诊断价值。结果病例组血清ESM1(323.05±45.17 mmol/L),LRP1(12.25±0.97μg/ml)水平高于对照组(195.20±31.67 mmol/L,6.41±0.84μg/ml),差异具有统计学意义(t=23.291,47.677,均P<0.05)。重度组患者血清ESM1(672.44±83.61 pg/ml),血清LRP1(14.52±1.05μg/ml)、舒张压(113.17±12.24mmHg)、收缩压(165.19±16.63mmHg)、24h尿蛋白量(2.63±0.45g/24h)、血肌酐(74.47±20.82μmol/L)、血尿素氮(4.32±0.78mmol/L)、血尿酸(339.65±50.13μmol/L)高于轻度组(551.74±72.20 pg/ml,9.63±0.89μg/ml,92.41±9.29mmHg,147.25±14.66mmHg,1.42±0.33g/24h,69.64±15.07μmol/L,3.95±0.91mmol/L,303.82±41.71μmol/L),新生儿体质量低于轻度组(2.73±0.62 kg vs 3.20±0.62 kg),差异具有统计学意义(t=1.980~37.978,均P<0.05)。病例组患者血清ESM1及LRP1水平与舒张压、收缩压、24h尿蛋白定量、血肌酐、血尿素氮及血尿酸呈正相关(r=0.413~0.515,均P<0.05),与胎儿体质量呈负相关(r=-0.563,-0.604,均P<0.05)。高血清ESM1水平(OR=1.217,95%CI:1.036~1.429)和高血清LRP1水平(OR=1.486,95%CI:1.056~2.090)是影响早发型重度子痫前期发生的独立危险因素。血清ESM1联合LRP1诊断早发型重度子痫前期的曲线下面积(area under the curve,AUC)0.884(0.853~0.916)大于ESM1(AUC=0.749,95%CI:0.705~0.792)和LRP1(AUC=0.760,95%CI:0.712~0.807)单独诊断(Z=6.752,4.297,均P<0.05)。结论早发型子痫前期患者血清ESM1和LRP1水平升高,二者均与早发型子痫前期疾病严重程度有关,联合检测能提高早发型重度子痫前期的诊断效能。
