妊高征孕妇围生期血浆D-二聚体、T细胞亚群及CRP水平与胎儿Apgar评分的相关性

摘要

Objective It is to explore the correlation of plasma D -dimer ( D-D) , T lymphocyte subsets , CRP level with Apgar score of neonates in pregnant women with pregnancy-induced hypertension ( PIH) during perinatal period .Methods 120 pregnant women with PIH were selected as observation group , and 60 healthy pregnant women were selected as control group . Plasma D-D, CD4 +and CD8 +T cell lymphocyte subsets and CRP level of the two groups were detected before and 3d after delivery , and Apgar scores of neonates were recorded after delivery .By applying Pearson correlation analysis , the correlation of plasma D-dimer, T lymphocyte subsets proportion , CRP level and Apgar score of neonates was analyzed .Besides, the correlation of D-dimer, CD4+/CD8 +, CRP index, and Apgar score of neonates was analyzed by multiple logistic regression analysis.Results There was no statistical difference in plasma D -D, CD4+/CD8 +and CRP before and 3d after delivery in control group (P>0.05), while observation group’s plasma D-D and CRP decreased (P<0.05), and CD4 +/CD8 +in-creased (P<0.05).By comparison, D-dimer, CRP, and CD4 +/CD8 +before and 3d after delivery in observation group were all higher than those in control group (P<0.05).By Pearson correlation, it showed that D -dimer, CD4 +/CD8+, CRP and Apgar score of neonates were both negative correlation with each other (P<0.05).By multiple logistic regression a-nalysis, D-dimer and CD4 +/CD8 +are independent forecast factors for Apgar score of neonates (OR=0.673, P=0.032;OR=0.543, P=0.026).Conclusion Plasma D-dimer, T lymphocyte subsets and CRP in pregnant women with PIH during perinatal period have clinical value for assessment of Apgar score of neonates .%目的：探讨妊娠高血压综合征孕妇围生期血浆D-二聚体（ D-dimer ）、T细胞亚群、C反应蛋白（ CRP）与胎儿Apgar评分的相关性。方法选取妊高征孕妇120例设为观察组；另选取同期孕检的健康孕妇60例设为对照组。检测2组孕妇分娩前、分娩后第3天血浆D-dimer、CD4＋及CD8＋T细胞亚群百分率及CRP水平，并记录每位孕妇分娩即刻胎儿Apgar评分。应用Pearson相关分析对血浆D-dimer、T细胞亚群比例及CRP水平与胎儿Ap-gar评分进行相关性分析。再应用多元Logistic回归分析对D-dimer、CD4＋/CD8＋、CRP指标与胎儿Apgar评分的相关性进行分析。结果与分娩前相比，分娩后第3天对照组血浆D-dimer、CD4＋/CD8＋与CRP水平无明显变化（P均＞0．05），而观察组中D-dimer、CRP水平显著降低（P均＜0．05），CD4＋/CD8＋显著增加（P均＜0．05）；与对照组相比，分娩前与分娩后第3天观察组血浆D-di-mer、CRP、CD4＋/CD8＋均较高（ P均＜0．05）。 Pearson相关分析显示，血浆D-dimer、CD4＋/CD8＋、CRP指标与胎儿Apgar评分均呈负相关（P＜0．05）；经多元Logistic回归分析血浆D-dimer与CD4＋/CD8＋是分娩后即刻胎儿的Apgar评分的独立预测因子（OR＝0．673，P＝0．032；OR＝0．543，P＝0．026）。结论妊高征孕妇围生期血浆D-dimer、T细胞亚群与CRP对评估胎儿Apgar评分有临床价值。