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目的探讨脂联素与D-二聚体检测在妊娠期高血压中的临床价值。方法选择2011年11月—2014年9月就诊的妊娠期高血压患者96例,其中轻度妊娠期高血压39例作为轻度组,中度妊娠期高血压31例作为中度组,重度妊娠期高血压26例作为重度组,另外选取同期进行产检的健康孕妇35例作为对照组。测量四组孕妇的血压,测3次取平均值。四组孕妇均空腹抽取周静脉血检测脂联素、D-二聚体。计数资料用±s表示,采用t检验,血清脂联素、D-二聚体水平与血压的相关性Spearman相关分析,P<0.05差异有统计学意义。结果轻度组血清脂联素水平为(8.84±1.97)ug/L,与对照组的(9.37±3.08)ug/L比较,差异无统计学意义(P>0.05),中度组、重度组血清脂联素水平[(5.64±2.13)、(3.95±1.42)ug/L]与对照组比较,差异均有统计学意义(均P<0.05),轻度组、中度组、重度组血清脂联素水平逐渐下降,比较差异均有统计学意义(均P<0.05)。轻度组血清D-二聚体水平为(0.24±0.06)ug/m L,与对照组的(0.16±0.07)ug/ml比较,差异无统计学意义(P>0.05),中度组、重度组血清D-二聚体水平[(6.30±1.33)、(11.30±4.06)ug/ml]与对照组比较,差异均有统计学意义(均P<0.05),轻度组、中度组、重度组血清D-二聚体水平逐渐上升,比较差异均有统计学意义(均P<0.05)。采用直线相关对血清脂联素、D-二聚体水平与血压的相关性进行分析,血清脂联素水平与血压呈负相关,差异有统计学意义(r=-0.547,P<0.05),D-二聚体水平与血压呈正相关,差异有统计学意义(r=0.439,P<0.05)。结论脂联素与D-二聚体检测可以预测妊娠期高血压孕妇的血压水平及病情严重程度。
Objective To investigate the clinical value of adiponectin and D-dimer in detecting gestational hypertension. Methods 96 patients with gestational hypertension admitted to our hospital from November 2011 to September 2014 were enrolled. Among them, 39 cases of mild gestational hypertension were treated as mild group and 31 cases of moderate gestational hypertension as moderate group and severe pregnancy Twenty-six patients with hypertension were selected as severe group. Another 35 healthy pregnant women who underwent antenatal examination during the same period were selected as control group. Four groups of pregnant women to measure blood pressure, measured 3 times the average. Four groups of pregnant women were fasting blood samples were taken for determination of adiponectin, D-dimer. Count data with ± s said, using t test, serum adiponectin, D-dimer level and blood pressure Spearman correlation analysis, P <0.05 difference was statistically significant. Results The level of serum adiponectin in mild degree group was (8.84 ± 1.97) ug / L, which was not significantly different from that in control group (9.37 ± 3.08) ug / L (P> 0.05) Serum levels of adiponectin were significantly higher than those in the control group [(5.64 ± 2.13), (3.95 ± 1.42) ug / L, respectively, compared with the control group (all P <0.05) Adiponectin levels gradually decreased, the difference was statistically significant (P <0.05). The level of D-dimer in mild group was (0.24 ± 0.06) ug / m L, which was not significantly different from that in control group (0.16 ± 0.07) ug / ml (P> 0.05) The levels of serum D-dimer in severe group were significantly higher than those in control group [(6.30 ± 1.33) and (11.30 ± 4.06) ug / ml, respectively] (P <0.05) Serum levels of D-dimer in severe group increased gradually with significant difference (all P <0.05). The linear correlation between serum adiponectin, D-dimer and blood pressure was analyzed. The level of serum adiponectin was negatively correlated with blood pressure (r = -0.547, P <0.05) D-dimer levels and blood pressure was positively correlated, the difference was statistically significant (r = 0.439, P <0.05). Conclusion The determination of adiponectin and D-dimer can predict the blood pressure and the severity of the disease in pregnant women with gestational hypertension.