本文關(guān)鍵詞：D二聚體在子癇前期患者血漿水平的變化及與血脂水平的相關(guān)性　出處：《青島大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 子癇前期 D二聚體 血脂 血壓

【摘要】：背景子癇前期(Pre-Eclampsia,PE)是妊娠期高血壓疾病的類型之一,主要病理變化為全身小動脈痙攣,臨床表現(xiàn)以妊娠20周后出現(xiàn)高血壓、蛋白尿、水腫為特征并伴全身多臟器的損害,分娩后可隨之消失。該病嚴(yán)重影響母嬰健康,是引起胎兒生長發(fā)育受限及孕產(chǎn)婦和圍生兒死亡的主要原因。及時(shí)而準(zhǔn)確地預(yù)測PE的發(fā)生,盡早采取相應(yīng)的干預(yù)措施,對改善母嬰預(yù)后有重要意義,但目前預(yù)測PE發(fā)生的指標(biāo)在預(yù)測準(zhǔn)確性上或多或少都存在一些缺陷。目的本研究通過比較PE患者與正常孕婦血漿D二聚體水平,并分析兩者血漿D二聚體與血壓、血脂水平的相關(guān)性,探討D二聚體在預(yù)測和治療PE中的價(jià)值和意義。方法選擇88例PE患者及43例正常妊娠孕婦作為研究對象,按中華醫(yī)學(xué)會婦產(chǎn)科學(xué)分會《妊娠期高血壓疾病診治指南(2012版)》的相關(guān)規(guī)定分為輕度PE組32例、重度PE組56例、正常妊娠組43例。所有孕婦均無其它并發(fā)癥。所有受試者清晨經(jīng)肘靜脈空腹采血檢測血清D二聚體、血總膽固醇(Total Cholesterol,TC)、甘油三酯(Triglyceride,TG)以及出、凝血等相關(guān)指標(biāo),分析對比三組相關(guān)指標(biāo)的水平。結(jié)果PE患者與正常妊娠婦女相比,血漿D二聚體水平有顯著升高(P0.05),且PE重度患者血漿D二聚體水平顯著高于輕度患者(P0.05)。血漿D二聚體診斷PE的ROC曲線下面積為0.901,當(dāng)血漿D二聚體取值0.685 ug/ml時(shí)預(yù)測PE的敏感性為0.962,特異性為0.714,95%置信區(qū)間為(0.729,1)�；颊逥二聚體水平隨著收縮壓(Systolic Blood Pressure,SBP)和舒張壓(Diastolic Blood Pressure,DBP)水平升高而升高,和DBP呈顯著正相關(guān)(P0.01),并且和TG、TC含量也呈顯著正相關(guān)(P0.05或P0.01),與腎功能障礙指標(biāo)也呈正相關(guān)(P0.05或P0.01),正常妊娠組這五項(xiàng)指標(biāo)無明顯相關(guān)性。結(jié)論D二聚體水平與PE病情發(fā)展密切相關(guān),與患者血壓、血脂水平呈正相關(guān),是評估PE病情的良好指標(biāo)。
[Abstract]:Background Preeclampsia preeclampsia (PEI) is one of the types of hypertensive disorder complicating pregnancy. The main pathological changes are arteriospasm of the whole body. The clinical manifestations were hypertension, proteinuria and edema after 20 weeks of pregnancy, accompanied by damage of multiple organs of the whole body, and then disappeared after delivery. The disease seriously affected the health of mother and child. It is the main cause of fetal growth and development restriction and maternal and perinatal death. Timely and accurate prediction of PE and taking corresponding intervention measures as early as possible are of great significance to improve the prognosis of mother and child. But there are some defects in predicting the accuracy of PE. Objective to compare plasma D-dimer levels between PE patients and normal pregnant women. The relationship between plasma D-dimer and blood pressure, blood lipid level was analyzed. To explore the value and significance of D-dimer in predicting and treating PE. Methods 88 patients with PE and 43 pregnant women with normal pregnancy were selected as subjects. According to the relevant provisions of the Chinese Medical Association of Gynecology and Obstetrics and Gynecology Society < guidelines for the diagnosis and treatment of Hypertension complicating pregnancy (2012) >, they were divided into mild PE group (n = 32) and severe PE group (n = 56). There were 43 cases in normal pregnancy group. No other complications were found in all pregnant women. Serum D dimer and total cholesterol total Cholesterol were measured by fasting blood samples collected from all subjects through cubital vein in the morning. TCX, triglyceride-triglyceride (TGG), blood coagulation and other related indexes were analyzed and compared among the three groups. Results PE patients were compared with normal pregnant women. Plasma D dimer level was significantly increased (P 0.05). The level of plasma D-dimer in severe PE patients was significantly higher than that in mild patients (P0.050.The area under the ROC curve of plasma D-dimer diagnosis was 0.901). When the plasma D-dimer value was 0.685 ug/ml, the sensitivity of predicting PE was 0.962, the specificity was 0.714 ~ 95% confidence interval (CI) was 0.729. The level of D-dimer with systolic Blood Pressure. The levels of SBP) and diastolic Blood pressure (DBP) increased, and there was a significant positive correlation between SBP and DBP, and there was a significant correlation between SBP and TG. TC content also showed significant positive correlation (P0.05 or P0.01), and also positively correlated with renal dysfunction (P0.05 or P0.01). Conclusion the level of D dimer is closely related to the development of PE, and is positively correlated with the blood pressure and blood lipid level, and is a good index to evaluate the condition of PE.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R714.244

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 李麗娜,王曉寧,原亞文,熊紅梅,耿俐,劉德懷;正常妊娠和妊高征孕婦血漿D-二聚體含量的變化[J];中國實(shí)用婦科與產(chǎn)科雜志;2001年10期

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