血清抗心磷脂抗体、同型半胱氨酸、D-二聚体水平与妊娠期高血压患者病情及妊娠结局的相关性分析  

Correlation analysis of serum levels of anticardiolipin antibody,homocysteine and D-dimer with the disease and pregnancy outcome of hypertensive patients during pregnancy

作　　者：张志龙 楚帅斐 周丹 王敏 ZHANG Zhilong;CHU Shuaifei;ZHOU Dan;WANG Min(Department ofObstetrics,Luohe Central Hospital,Luohe 462000;Department of Neonatology,Luohe Central Hospital,Luohe 462000;Department of Obstetrics and Gynecology,Henan Provincial People's Hospital,Zhengzhou 450000,China)

机构地区：[1]漯河市中心医院产科,河南漯河462000 [2]漯河市中心医院新生儿科,河南漯河462000 [3]河南省人民医院妇产科,河南郑州450000

出　　处：《黑龙江医药科学》2024年第4期45-48,共4页Heilongjiang Medicine and Pharmacy

基　　金：河南省医学科技攻关联合共建项目,编号:LHGJ20221039。

摘　　要：目的:分析妊娠期高血压(hypertensive disorder complicating pregnancy,HDCP)患者血清抗心磷脂抗体(anticardiolipin antibody,ACA)、同型半胱氨酸(homocysteine,Hcy)、D-二聚体(D-dimer,D-D)水平,并探讨其与病情严重程度相关性及其对妊娠结局的预测价值。方法:回顾性选取2021年7月至2023年7月漯河市中心医院收治的94例HDCP患者作为观察组,另选取同期健康孕妇47例作为对照组。比较两组血清ACA、Hcy、D-D水平。依据病情严重程度分为轻度49例、中度27例、重度18例;依据妊娠结局分为不良结局27例、良好结局67例,比较其血清ACA、Hcy、D-D水平。分析妊娠结局的影响因素。分析血清ACA、Hcy、D-D水平对妊娠结局的预测价值。结果:观察组血清ACA、Hcy、D-D水平高于对照组(P<0.05);重度患者血清ACA、Hcy、D-D水平>中度>轻度(P<0.05);不良结局者治疗前、治疗7 d后血清ACA、Hcy、D-D水平高于良好结局(P<0.05);高血压家族史及治疗前血清ACA、Hcy、D-D水平为妊娠结局的独立危险因素(P<0.05);治疗前血清ACA、Hcy、D-D联合预测妊娠结局的AUC大于任意两项指标联合预测、单项指标预测(P<0.05)。结论:HDCP患者血清ACA、Hcy、D-D水平升高,且与病情严重程度、不良妊娠结局密切相关,联合检测其水平对妊娠结局具有一定预测价值。Objective:To analyze the serum levels of anticardiolipin antibody(ACA),homocysteine(Hcy)and D-dimer(D-D)in patients with pregnancy-induced hypertension(HDCP),and to explore their correlation with the severity of the disease and their predictive value for pregnancy outcomes.Methods:A total of 94 HDCP patients admitted to our hospital from July 2021 to July 2023 were selected as the observation group,and 47 healthy pregnant women were selected as the control group.Serum ACA,Hcy and D-D levels were compared between the two groups.According to the severity of the disease,the patients were divided into mild 49 cases,moderate 27 cases and severe 18 cases.According to the pregnancy outcome,the patients were divided into 27 cases with bad outcome and 67 cases with good outcome.The serum ACA,Hcy and D-D levels were compared.The influencing factors of pregnancy outcome were analyzed.To analyze the predictive value of serum ACA,Hcy and D-D levels on pregnancy outcome.Results:The levels of ACA,Hcy and D-D in the observation group were higher than those in the control group(P<0.05).Serum ACA,Hcy and D-D levels in severe patients were>moderate>mild(P<0.05);The levels of ACA,Hcy and D-D in patients with adverse outcomes were higher than those in good outcomes before and 7 days after treatment(P<0.05).Family history of hypertension and serum ACA,Hcy and D-D levels before treatment were independent risk factors for pregnancy outcomes(P<0.05).The AUC of the combination of serum ACA,Hcy and D-D before treatment was greater than that of the combination of any two indicators and the single indicator(P<0.05).Conclusion:Serum ACA,Hcy and D-D levels in HDCP patients are elevated,which is closely related to the severity of the disease and adverse pregnancy outcome.The combined detection of ACA,HCY and D-D levels has certain predictive value for pregnancy outcome.

关 键 词：妊娠期高血压 抗心磷脂抗体 同型半胱氨酸 D-二聚体 预测 妊娠结局 

分 类 号：R714.246[医药卫生—妇产科学]