地塞米松对妊娠期血小板减少综合征患者的PLT、LDH、AST、ALT及妊娠结局的影响

摘要

Objective To study the effect of Dexamethasone on blood platelet count (PLT ) ,lactate dehydrogenase(LDH ) ,as-pertate aminotransferase(AST) ,alanine aminotransferase(ALT )and pregnancy outcome in patients with gestational thrombocytope-nia syndrome .Methods A total of 60 pregnant women with thrombocytopenia syndrome from March 2014 to April 2015 in our hospital were recruited into observation group ,according to the platelet count ,60 patients were divided into class Ⅰ ,class Ⅱ and class Ⅲ group ,20 cases in each group .Another 60 normal delivery of healthy pregnant women were recruited as control group .The patients of observation group were given Dexamethasone .The levels of PLT ,LDH ,AST ,ALT ,and complications ,pregnant out-come ,prognosis were compared in the two groups and grade Ⅰ ,grade Ⅱ and grade Ⅲ group .Results After treatment ,the PLT and LDH in the observation group recovered to the normal standard ,which had no significant differences compared with those in the control subjects(P> 0 .05) .The complications and perinatal mortality in observation group were obviously higher than those in the control group(P< 0 .05) .After treatment ,the recovery time of PLT of patients of grade Ⅰ in the observation group was(4 .78 ± 1 .45)d ,which was significant higher than (2 .82 ± 0 .86)d of grade Ⅲ patients(P< 0 .05) .The adverse pregnancy outcomes in pa-tients with grade Ⅰ group(50 .00% )was significant higher than those of grade Ⅱ group(25 .00% )and the level Ⅲ (20 .00% )of the patients(P< 0 .05) .Conclusion Dexamethasone could effectively improve the adverse pregnancy outcomes and the prognosis of pa-tients with gestational thrombocytopenia syndrome ,but the curative effect has close relationship with clinical classification .%目的：研究地塞米松对妊娠期血小板减少综合征患者的血小板计数（PLT ）、乳酸脱氢酶（LDH）、天门冬氨酸氨基转移酶（AST ）、丙氨酸氨基转移酶（ALT ）及其妊娠结局的影响。方法将2014年3月至2015年4月在该院接受治疗的血小板减少综合征孕妇60例纳入观察组，根据其 PLT 减少程度分为Ⅰ级组、Ⅱ级组、Ⅲ级组，每组各20例，并选择同期60例健康孕妇作为对照组。给予观察组患者地塞米松治疗。对比两组孕妇及观察组中不同级别患者的 PLT 、LDH 、AST 、ALT 的水平，以及并发症、妊娠结局、预后等情况。结果治疗后，观察组的 PLT 和 LDH 的水平均达到了正常的标准，与对照组比较，差异无统计学意义（P＞0．05）。观察组患者的并发症发生率与围生儿死亡率明显高于对照组（P＜0．05）。治疗后，观察组中Ⅰ级组的患者其血小板恢复时间为（4．78±1．45）d ，明显高于Ⅲ级组患者的（2．82±0．86）d ，差异有统计学意义（P＜0．05）。其Ⅰ级组患者的不良妊娠结局（50．00％）均明显高于Ⅱ级组（25．00％）与Ⅲ级组（20．00％）的患者（P ＜0．05）。结论地塞米松治疗妊娠期血小板减少综合征，能够有效改善其不良的妊娠结局及患者的预后，但其疗效与临床分级有密切的关系。