【作者】 闫妍；

【导师】 金仁顺；

【作者基本信息】 延边大学 ， 病理学与病理生理学， 2011， 硕士

【摘要】 目的探讨妊娠期高血压疾病患者血清蛋白含量和凝血功能指标的临床意义。方法1.分析妊娠期高血压疾病孕妇89例(妊娠期高血压19例,轻度子痫前期22例,重度子痫前期晚发型21例,早发型27例)患者的临床资料、血清总蛋白、白蛋白及球蛋白的检测结果,并与18例正常晚期妊娠进行比较。2.分析97例妊娠期高血压疾病(妊娠期高血压21例、轻度子痫前期26例、重度子痫前期早发型24例和重度子痫前期晚发型26例)患者的血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)及血浆纤维蛋白原(FIB)含量的检测结果,并与20例正常晚期妊娠进行比较。结果1.正常妊娠组、妊娠期高血压组,轻度子痫前期组、重度子痫前期晚发型和早发型组血清总蛋白的含量逐渐下降；早发型组与正常妊娠组、妊娠期高血压组比较均有显著性差异(P<0.001)；晚发型组与正常组比较有统计学意义(P<0.05)；白蛋白含量逐渐下降,早发型组、晚发型组与妊娠期高血压组比较均有显著性差异(P<0.001)；早发型组球蛋白含量明显下降,与正常组比较有显著性差异(P<0.001)；各组低蛋白血症的发生率逐渐增高,早发型组最高,与各组比较均有显著性差异(P<0.001)。2.重度子痫前期早发型组血小板计数明显下降,与晚发型组比较有差异(P<0.05),血小板减少症的发生率高达50%；早发型组与晚发型组比较PT和APTT值减少,但无统计学意义,而早发型组TT值最高；早发型组FIB含量下降,与晚发型组比较有统计学意义(P<0.05)。结论1.妊娠期高血压疾病患者的血清白蛋白水平是疾病严重程度的重要决定因素,血清白蛋白水平可作为预测子痫前期严重程度的有用的指标。2.PLT和FIB含量可作为妊娠期高血压疾病严重程度的重要指标,而PT、APTT和TT值不能反映妊娠高血压疾病的严重程度。更多还原

【Abstract】 Objective To explor the clinical significance of serum protein levels and coagulation indexes in hypertensive disorders in pregnancy(HDP).Methods 1. Serum levels of total protein(TP), albumin, globumin and clinical data were analyzed in19 cases of gestational hypertension(GH),22 cases with mild pre-eclampsia(MPE),27 cases of early onset severe pre-eclampsia(EOSP),21 cases with late onset severe preeclampsia(LOSP) and 18 cases of normal late pregnancy women(NLP).2. Blood platelet count (PLT), PT, APTT, TT and fibrinogen (FIB) level were analyzed in 21 cases of gestational hypertension, (GH),26 cases with mild pre-eclampsia(MPE),24 cases of early onset severe pre-eclampsia(EOSP),26 cases with late onset severe pre-eclampsia(LOSP) and 20 cases of normal late pregnancy women(NLP).Results 1. Serum levels of TP were gradually decreased in NLP, GH, MPE, LOSP and EOSP groups, there were significance differences among EOSP, NLP and GH groups (P<0.001), and there were also significance differences between LOSP and NLP groups (P<0.05).Serum levels of albumin were also gradually decreased, and there were significance differences among EOSP, LOSPS and GH groups (P<0.001). Serum level of globumin was markedly decreased in EOSP group, there was significance differences between EOSP and NLP groups (P<0.001). Hypoproteinemia rates were gradually increased and there were significance differences among EOSP and other groups (P<0.001)2.PLT was markedly lower in EOSP group than that of LOSP group, there was significance differences(P<0.01), the rate of thrombocytopenia was 50% in EOSP group; the PT and APTT were lower in EOSP than that of LOSP group,there were no significance differences, but TT was hihger in EOSP group; the level of FIB was significantly decreased in EOSP gorup than that of LOSP group, and there was significance differences(P<0.01).Conclusion 1.Serum albumin levels is a significant determinant of disease severity in pregnancy related hypertension, and may be considered as a useful marker for predicting to severity of pre-eclampsia.2.PLT and level of FIB were significance decreased in EOSP group and it’s a important determinant of disease severity, but the PT、APTT and TT can not reflect the severity of hypertensive disorders in pregnancy.更多还原