机构地区:[1]杭州市萧山区第一人民医院,浙江杭州311200
出 处:《中国妇幼健康研究》2018年第4期441-444,共4页Chinese Journal of Woman and Child Health Research
摘 要:目的探讨妊娠期肝内胆汁淤积症(ICP)患者纤维蛋白原(FIB)、D-二聚体(D-D)、血小板(PLT)、白介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)及血液流变学指标等的变化。方法将2015年6月至2016年12月于杭州市萧山区第一人民医院分娩的90例ICP患者纳入本研究,作为实验组,并以同期体检健康的90例孕妇作为对照组,检测并比较两组FIB、D-D、PLT、IL-18、TNF-α及血液流变学指标等的变化。结果实验组孕妇的血浆黏度、全血黏度(高切和低切)、红细胞压积和血沉均明显高于对照组,差异具有统计学意义(t值分别为8.85、10.04、7.35、16.22、20.45,均P<0.01)。与对照组相比,实验组产妇的FIB、D-D均明显较高,而PLT明显较低,差异具有统计学意义(t值分别为8.64、12.73、18.62,均P<0.01)。另外,两组的凝血酶原时间(PT)和部分凝血酶原时间(PPT)组间比较无显著性差异(t值分别为1.91、1.65,均P>0.05)。实验组产妇的IL-12、IL-18及TNF-α水平均明显高于对照组(t值分别为70.29、48.76、29.93,均P<0.01);实验组孕妇早产、羊水污染、胎儿宫内窘迫、新生儿窒息和低体重儿的发生率均明显高于对照组,差异均有统计学意义(χ~2值分别为12.13、19.74、4.81、5.71、4.06,均P<0.05)。结论 ICP患者的血液明显高黏、高凝,且炎症因子高表达,与妊娠不良妊娠结局密切相关。Objective To investigate the changes of fibrinogen (FIB), D-Dimer (D-D), platelet, IL-18, TNF-α and hemorheological indexes in patients with intrahepatic cholestasis of pregnancy(ICP). Methods Ninety patients with ICP delivering in the First People's Hospital of Xiaoshan District from June 2015 to December 2016 were enrolled in experimental group, and 90 healthy pregnant women were selected as control group. The changes of FIB, D-D, platelet, IL-18, TNF-α and hemorheological indexes were detected and compared between two groups. Results The plasma viscosity, whole blood viscosity (high shear and low shear), hematocrit and erythrocyte sedimentation rate in the experimental group were significantly higher than those in the control group (t value was 8.85, 10.04, 7.35, 16.22 and 20.45, respectively, all P〈0.01 ). Compared with the control group, the FIB and D-D of the patients in the experimental group were significantly higher but PLT was lower, and the differences were significant (t value was 8.64, 12.73 and 18.62, respectively, all P〈0.01 ). In addition, there were no significant differences between two groups in prothrombin time (PT) and partial prothrombin time ( PPT ) (t value was 1.91 and 1.65, respectively, both P〉0.05 ). The levels of IL-12, IL-18 and TNF-α in the experimental group were significantly higher than those in the control group (t value was 70.29, 48.76 and 29.93, respectively, all P〈0.01 ). The incidences of preterm labor, amniotic fluid pollution, fetal distress, neonatal asphyxia and low birth weight in the experimental group were significantly higher than those in the control group (χ^2 value was 12.13, 19.74, 4.81, 5.71 and 4.06, respectively, all P〈0.05).Conclusion Viscosity and coagulation of blood of patients with ICP are high and the expression of inflammatory factors is high, which is closely related to the adverse pregnancy outcomes.
关 键 词:妊娠期肝内胆汁淤积症 凝血功能 血液流变学 妊娠结局
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