D二聚体在子痫前期患者血浆水平的变化及与血脂水平的相关性

发布时间：2018-01-07 15:03

本文关键词：D二聚体在子痫前期患者血浆水平的变化及与血脂水平的相关性　出处：《青岛大学》2015年硕士论文　论文类型：学位论文

【摘要】：背景子痫前期(Pre-Eclampsia,PE)是妊娠期高血压疾病的类型之一,主要病理变化为全身小动脉痉挛,临床表现以妊娠20周后出现高血压、蛋白尿、水肿为特征并伴全身多脏器的损害,分娩后可随之消失。该病严重影响母婴健康,是引起胎儿生长发育受限及孕产妇和围生儿死亡的主要原因。及时而准确地预测PE的发生,尽早采取相应的干预措施,对改善母婴预后有重要意义,但目前预测PE发生的指标在预测准确性上或多或少都存在一些缺陷。目的本研究通过比较PE患者与正常孕妇血浆D二聚体水平,并分析两者血浆D二聚体与血压、血脂水平的相关性,探讨D二聚体在预测和治疗PE中的价值和意义。方法选择88例PE患者及43例正常妊娠孕妇作为研究对象,按中华医学会妇产科学分会《妊娠期高血压疾病诊治指南(2012版)》的相关规定分为轻度PE组32例、重度PE组56例、正常妊娠组43例。所有孕妇均无其它并发症。所有受试者清晨经肘静脉空腹采血检测血清D二聚体、血总胆固醇(Total Cholesterol,TC)、甘油三酯(Triglyceride,TG)以及出、凝血等相关指标,分析对比三组相关指标的水平。结果PE患者与正常妊娠妇女相比,血浆D二聚体水平有显著升高(P0.05),且PE重度患者血浆D二聚体水平显著高于轻度患者(P0.05)。血浆D二聚体诊断PE的ROC曲线下面积为0.901,当血浆D二聚体取值0.685 ug/ml时预测PE的敏感性为0.962,特异性为0.714,95%置信区间为(0.729,1)。患者D二聚体水平随着收缩压(Systolic Blood Pressure,SBP)和舒张压(Diastolic Blood Pressure,DBP)水平升高而升高,和DBP呈显著正相关(P0.01),并且和TG、TC含量也呈显著正相关(P0.05或P0.01),与肾功能障碍指标也呈正相关(P0.05或P0.01),正常妊娠组这五项指标无明显相关性。结论D二聚体水平与PE病情发展密切相关,与患者血压、血脂水平呈正相关,是评估PE病情的良好指标。
[Abstract]:Background Preeclampsia preeclampsia (PEI) is one of the types of hypertensive disorder complicating pregnancy. The main pathological changes are arteriospasm of the whole body. The clinical manifestations were hypertension, proteinuria and edema after 20 weeks of pregnancy, accompanied by damage of multiple organs of the whole body, and then disappeared after delivery. The disease seriously affected the health of mother and child. It is the main cause of fetal growth and development restriction and maternal and perinatal death. Timely and accurate prediction of PE and taking corresponding intervention measures as early as possible are of great significance to improve the prognosis of mother and child. But there are some defects in predicting the accuracy of PE. Objective to compare plasma D-dimer levels between PE patients and normal pregnant women. The relationship between plasma D-dimer and blood pressure, blood lipid level was analyzed. To explore the value and significance of D-dimer in predicting and treating PE. Methods 88 patients with PE and 43 pregnant women with normal pregnancy were selected as subjects. According to the relevant provisions of the Chinese Medical Association of Gynecology and Obstetrics and Gynecology Society < guidelines for the diagnosis and treatment of Hypertension complicating pregnancy (2012) >, they were divided into mild PE group (n = 32) and severe PE group (n = 56). There were 43 cases in normal pregnancy group. No other complications were found in all pregnant women. Serum D dimer and total cholesterol total Cholesterol were measured by fasting blood samples collected from all subjects through cubital vein in the morning. TCX, triglyceride-triglyceride (TGG), blood coagulation and other related indexes were analyzed and compared among the three groups. Results PE patients were compared with normal pregnant women. Plasma D dimer level was significantly increased (P 0.05). The level of plasma D-dimer in severe PE patients was significantly higher than that in mild patients (P0.050.The area under the ROC curve of plasma D-dimer diagnosis was 0.901). When the plasma D-dimer value was 0.685 ug/ml, the sensitivity of predicting PE was 0.962, the specificity was 0.714 ~ 95% confidence interval (CI) was 0.729. The level of D-dimer with systolic Blood Pressure. The levels of SBP) and diastolic Blood pressure (DBP) increased, and there was a significant positive correlation between SBP and DBP, and there was a significant correlation between SBP and TG. TC content also showed significant positive correlation (P0.05 or P0.01), and also positively correlated with renal dysfunction (P0.05 or P0.01). Conclusion the level of D dimer is closely related to the development of PE, and is positively correlated with the blood pressure and blood lipid level, and is a good index to evaluate the condition of PE.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R714.244

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