妊娠晚期合并心脏病患者血清纤溶酶原激活物抑制剂-1、血管细胞黏附分子-1水平及意义  

Serum plasminogen activator inhibitor 1,vascular cell adhesion molecule 1 level and significance in patients with heart disease in late pregnancy

作　　者：赵冲[1] 王长君[1] 张倩怡 杨硕[1] 史玲玲 Zhao Chong;Wang Changjun;Zhang Qianyi;Yang Shuo;Shi Lingling(Department of Obstetrics, Shengjing Hospital Affiliated to China Medical University, Liaoning Province, Shenyang 110000,China)

机构地区：[1]中国医科大学附属盛京医院产科,沈阳110000

出　　处：《疑难病杂志》2020年第11期1129-1132,1137,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：辽宁省科学技术计划资助项目(2018223132)。

摘　　要：目的分析妊娠晚期合并心脏病患者血清纤溶酶原激活物抑制剂-1(PAI-1)、血管细胞黏附分子-1(VCAM-1)水平及临床意义。方法选取2018年2月—2019年12月中国医科大学附属盛京医院产科诊治的妊娠晚期合并心脏病患者100例作为病例组,依据美国心脏协会心功能分级标准分为4个亚组,Ⅰ级患者为Ⅰ级组(n=47)、Ⅱ级患者为Ⅱ级组(n=32)、Ⅲ级患者为Ⅲ级组(n=18)、Ⅳ级患者为Ⅳ级组(n=3),另外选取同期就诊于医院的91例正常妊娠者作为对照组。比较5组血清PAI-1、VCAM-1水平及心功能指标的差异,比较妊娠中有无发生不良心脏事件患者血清PAI-1、VCAM-1水平差异,采用Pearson法分析血清PAI-1、VCAM-1与心功能的相关性。结果与对照组比较,Ⅰ级~Ⅳ级组E峰、E/A、LVEF呈逐渐降低趋势,差异均有统计学意义(F/P=72.567/0.000、20.274/0.000、67.828/0.000);A峰、LVESD、LVEDD呈逐渐升高趋势,差异均有统计学意义(F/P=26.007/0.000、153.207/0.000、36.126/0.000);与对照组比较,Ⅰ级~Ⅳ级组血清PAI-1、VCAM-1水平依次升高,差异均有统计学意义(F/P=440.645/0.000、74.427/0.000);发生不良心脏事件的妊娠晚期合并心脏病患者血清PAI-1、VCAM-1平均水平均明显高于未发生者(t/P=17.246/0.000、8.704/0.000);Pearson相关分析得出,血清PAI-1、VCAM-1水平与E峰、E/A、LVEF均呈负相关(PAI-1:r/P=-0.476/0.000、-0.532/0.000、-0.588/0.000;VCAM-1:-0.461/0.000、-0.468/0.000、-0.406/0.000),与A峰、LVESD、LVEDD均呈正相关(PAI-1:r/P=0.562/0.000、0.432/0.000、0.467/0.000;VCAM-1:0.512/0.000、0.594/0.000、0.503/0.000)。结论妊娠晚期合并心脏病患者血清中PAI-1、VCAM-1水平显著上升,且随心脏功能受损加重而升高,PAI-1、VCAM-1参与妊娠晚期合并心脏病的发生与发展,可用于妊娠晚期合并心脏病的病情评估及不良心脏事件预测。Objective To analyze the levels of serum plasminogen activator inhibitor 1(PAI-1)and vascular cell adhesion molecule 1(VCAM-1)in patients with heart disease in the third trimester of pregnancy and their clinical significance.Methods From February 2018 to December 2019,100 patients with heart disease in late pregnancy who were diagnosed and treated by the Department of Obstetrics,Shengjing Hospital,China Medical University,were selected as the observation group.According to the American Heart Association cardiac function classification standard,they were divided into 4 subgroups,grade I patients It is the grade I group(n=47),the grade II patients are the grade II group(n=32),the grade III patients are the grade III group(n=18),the grade IV patients are the grade IV group(n=3),and The 91 normal pregnant patients who were in the hospital during the same period were selected as the control group.The differences in serum PAI-1,VCAM-1 levels and cardiac function indexes of the 5 groups were compared,and the differences in serum PAI-1,VCAM-1 levels were analyzed whether adverse cardiac events occurred during pregnancy.Pearson method was used to analyze the correlation between serum PAI-1,VCAM-1 and cardiac function.Results Compared with the control group,the E peak,E/A and LVEF of the gradeⅠ~Ⅳgroup showed a gradual decrease trend,and the difference was statistically significant(F/P=72.567/0.000,20.274/0.000,67.828/0.000);A peak LVESD,LVEDD showed a gradual increase trend,and the differences were statistically significant(F/P=26.007/0.000,153.207/0.000,36.126/0.000);compared with the control group,serum PAI-1,VCAM-1 in the grade I to IV The level of 1 increased successively,and the difference was statistically significant(F/P=440.645/0.000,74.427/0.000);the serum PAI-1,VCAM-1 average level of patients with heart disease in late pregnancy who had adverse cardiac events was significantly higher than that of no Occurred(t/P=17.246/0.000,8.704/0.000);Pearson correlation analysis showed that serum PAI-1,VCAM-1 levels were

关 键 词：妊娠晚期 心脏病 纤溶酶原激活物抑制剂-1 血管细胞黏附分子-1 

分 类 号：R54[医药卫生—心血管疾病]