D-二聚体及子宫动脉血流在妊娠期高血压疾病中的意义

目的 探讨D-二聚体及子宫动脉血流在妊娠期高血压疾病中的意义。方法 采用回顾性研究调查检测120例正常妊娠、34例妊娠期高血压、52例轻度子前期、43例重度子前期孕妇外周血D-二聚体及双侧子宫动脉血流。结果 D-二聚体水平随孕周上升而增高,孕10~14周及孕30~34周外周血D-二聚体含量在正常组(0.11±0.03、0.35± 0.79) mg/L明显低于妊娠期高血压组(0.16±0.14、0.74±1.31) mg/L、轻度子前期组(0.35±0.28、2.13 ±2.27) mg/L、重度子前期组(0.56±0.42、2.98±2.96) mg/L (P<0.01)。妊娠期高血压组孕10~14周,30~34周外周血D-二聚体含量明显低于轻度子前期组及重度子前期组(P<0.01);轻度子前期组明显低于重度子前期组(P<0.01)。子宫动脉血流S/D比值正常组(2.13±0.41)明显低于妊娠期高血压组(2.33±0.21)、轻度子前期组(2.35±0.28)、重度子前期组(2.53±0.48)(P<0.01);妊娠期高血压组明显低于轻度子前期组及重度子前期组(P<0.01)。轻度子前期组明显低于重度子前期组(P<0.01);妊娠期高血压组的D-二聚体含量与子宫动脉S／D值成正比(R=-0.67),轻度子前期组的D-二聚体含量及重度子前期组的D-二聚体含量与子宫动脉S／D值成反比(R=0.75、0.81)。结论 监测孕妇外周血D-二聚体指标及子宫动脉血流,对妊娠期高血压疾病特别是重度子前期的早发现、早诊断、早治疗有一定的临床指导意义。
Objective To investigate significance of D-dimmer level and uterine artery blood flow in hypertensive disorders in pregnancy. Methods A retrospective review was done in 120 cases of normal pregnancy, 34 cases of gestational hypertension, 52 cases of mild preeclampsia and 43 cases of severe preeclampsia maternal peripheral blood D-dimmer and bilateral uterine artery blood flow. Results D-dimmer levels increased with gestational age increased. When 10-14 and 30-34 weeks of gestation week D-dimmers in normal pregnancy group (0.11±0.03,0.35±0.79) mg/L was lower than that of gestational hypertension group (0.16±0.14,0.74±1.31) mg/L, mild preeclampsia group(0.35±0.28,2.13±2.27) mg/L and severe preeclampsia group (0.56±0.42,2.98±2.96) mg/L (P<0.01). D-dimmer level in gestational hypertension group was significantly lower than that of mild preeclampsia group and severe preeclampsia group (P<0.01). D-dimmer level in mild preeclampsia group was significantly lower than that in severe preeclampsia group (P<0.01). The ratio of S/D in uterine artery blood flow of normal group (2.13±0.41) was significantly lower than that of gestational hypertension group (2.33±0.21), mild preeclampsia group (2.35±0.28) and severe preeclampsia group (2.53±0.48) (P<0.01). The ratio of S/D in gestational hypertension group was significantly lower than that of mild preeclampsia group and severe preeclampsia group,(P<0.01). The ratio of S/D in mild preeclampsia group was significantly lower than that of the severe preeclampsta group (P<0.01). The content of D-dimmer was proportional to the S/D value of uterine artery in gestational hypertension group (R=-0.67), but the content of D-dimmer in mild preeclampsia group and severe preeclampsia group was inversely proportional to the S/D value of uterine artery (R=0.75, 0.81). Conclusions Monitoring D-dimmer in peripheral blood and