Medical Recapitulate

摘要

目的：研究妊娠相关蛋白A（ PAPP－A）、胱抑素C（ CysC）、血同型半胱氨酸（ Hcy）在妊娠期高血压疾病患者体内水平和其临床价值。方法选择2013年9月至2014年10月青岛市胶州中心医院收治的80例妊娠期高血压疾病患者作为研究组，另选30例正常妊娠妇女作为对照组。对两组收缩压、舒张压、心率等常规指标进行对比分析。依照观察组疾病类型分为妊娠期高血压、子痫、轻度先兆子痫、重度先兆子痫4个亚组，比较各组PAPP－A、CysC、Hcy水平差异。结果研究组患者收缩压、舒张压、心率、血尿酸均显著高于对照组[（166±20） mmHg（1 mmHg ＝0．133 kPa）比（131±15） mmHg、（108±20） mmHg 比（85±10） mmHg、（101±8）次／min 比（85±6）次／min、（383±63）μmol／L 比（310±52）μmol／L]，白蛋白水平显著低于对照组[（30±7） g／L比（42±4） g／L]，差异有统计学意义（P＜0．05）。研究组PAPP－A、CysC、Hcy水平显著高于对照组[（37．0±7．7）μmol／L比（28．7±5．5）μmol／L、（1．5±0．4） mg／L 比（0．8±0．3） mg／L、（24．7±1．7）μmol／L 比（9．9±0．8）μmol／L]，差异有统计学意义（P＜0．05）。妊娠期高血压组、轻度先兆子痫组、重度先兆子痫组、子痫组患者PAPP－A、CysC、Hcy水平均依次升高，4组比较差异有统计学意义（ P＜0．05）。结论妊娠期高血压疾病患者血清中PAPP－A、CysC、Hcy水平均显著高于正常健康妊娠孕妇，病情越严重，其水平越高，对于妊娠期高血压疾病的临床诊治具有重要指导意义。%Objective To study the level of pregnancy associated protein A ( PAPP-A) ,serum cystatin C (Cys C),plasma homocysteine (Hcy) in patients with pregnancy induced hypertension and the clinical value. Methods Chosen from Sep.2013 to Oct.2014 in Qingdao Jiaozhou Central Hospital 80 cases of pregnancy induced hypertension were included as a study group and 30 cases of normal pregnant women were included as a control group.The systolic blood pressure,diastolic blood pressure and heart rate and other conventional indi-cators of the two groups were compared and analyzed .According to the disease type the study group was further divided into 4 sub-groups of gestational hypertension,eclampsia,mild preeclampsia,and severe preeclampsia, and PAPP-A,CysC and Hcy levels were compared.Results The systolic pressure,diastolic pressure,heart rate and serum uric acid of the study group were significantly higher than the control group [ ( 166 ±20 ) mmHg (1 mmHg=0.133 kPa) vs (131 ±15) mmHg,(108 ±20) mmHg vs (85 ±10) mmHg,(101 ±8) times/min vs (85 ±6) times/min,(383 ±63) μmol/L vs (310 ±52) μmol/L],albumin level was significantly lower than the control group[(30 ±7) g/L vs (42 ±4) g/L],the difference was statistically significant(P<0.05). The PAPP-A, CysC, Hcy of the study group were significantly higher than the control group [( 37.0 ± 7.7) μmol/L vs (28.7 ±5.5) μmol/L,(1.5 ±0.4) mg/L vs (0.8 ±0.3) mg/L,(24.7 ±1.7) μmol/L vs (9.9 ±0.8) μmol/L],the differences were statistically significant(P<0.05).The levels of PAPP-A,CysC and Hcy were increased in turn in the subgroups of hypertension ,mild preeclampsia group ,severe preeclampsia group and eclampsia group,the differences were statistically significant(P<0.05).Conclusion The serum levels of PAPP-A,CysC and Hcy are significantly higher in patients with pregnancy induced hypertension than the normal healthy pregnant women,the more serious the disease,the higher the level,which has great guiding significance for the clinical diagnosis and treatment of hypertension in pregnancy .