早发型与晚发型重度子痫前期临床生化指标比较

摘要

Objective To compare the clinical biochemical indicators between early onset preeclampsia ( EOSP )and late onset preeclampsia( LOSP )in order to provide scientific basis for anticoagulant therapy. Methods 220 patients with preeclampsia were enrolled in the study. These patients were divided into EOSP group and LOSP group according to gestational age( before or after 34 weeks ), then EOSP group was subdivided into mild degree group( group A, n =40 )and severe degree group( group B, n = 60 ), and LOSP group was sundivided into mild degree group( group C, n = 60 )and severe degree group( group D, n = 60 ). The differences of levels of thromboxane and fibrinolysis indexes including plasma homocysteine, blood fat, DD, t-PA, PAI-1 were compared among the four groups. Results The PT and APTT in group B were shortened,PLT was decreased too,however, the levels of Fg,DD,t-PA,PAI-1,plasma homocysteine were increased,as compared with those in group D( P < 0.05 ). The levels of TC,TG, LDL, apoB in group B were significantly higher than those in group D, however, the levels of HDL,apoA in group B were significantly lower than those in group D, there were significant differences between the two groups( P <0.05 ). Conclusion Anticoagulant treatment is necessary for the patients with early onset severe preeclampsia, because they have hyperlipidemia, hyperhomocysteinaemia, with being hypercoagulable states.%目的 对比早发型与晚发型子痫前期临床生化指标,为抗凝治疗提供依据.方法 选取子痫前期患者220例,以孕龄34周为界,分为早发型包括轻度40例(A组),重度60例(B组),与晚发型轻度60例(C组),重度60例(D组),对比4组凝血纤溶指标,血浆同型半胱氨酸,血脂的差异.结果 早发型重度子痫前期血凝血酶原时间(PT),活化部分凝血酶原时间(APTT)均缩短,血小板计数(PLT)下降,而纤维蛋白原(Fg)、D-二聚体(DD)、组织纤溶酶原激活物(t-PA)、组织纤溶酶原激活物抑制剂(PAI-1)均升高,血浆同型半胱氨酸升高,与晚发型对比,2组差异有统计学意义(P<0.05).早发型重度子痫前期患者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、载脂蛋血B(apoB)明显高于晚发组;而HDL、apoA低于晚发组,2组差异有统计学意义(P<0.05);结论 早发型重度子痫前期患者存在高脂血症,高同型半胱氨酸血症,处于过高凝状态,抗凝治疗很有必要.