重度子痫前期患者妊娠结局的预测

目的探讨各项生化指标在预测重度子痫前期患者妊娠结局中的意义。方法回顾性分析2010年6月至2010年12月在郑州大学第三附属医院住院的115例重度子痫前期患者和117例正常妊娠者的临床资料及各项生化指标,包括谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)、总蛋白、白蛋白、胆汁酸、尿素、肌酐、尿酸、β2-微球蛋白(β2-MG),比较两组资料的差异,同时,观察重度子痫前期患者的乳酸脱氢酶(LDH)水平,分析其与妊娠结局的关系。结果重度子痫前期组ALT(22.36±24.44)比(10.44±7.51)U/L]、AST(31.08±27.23)比(18.37±6.99)U/L]、GGT(28.47±39.81)比(10.79±7.50)U/L]、胆汁酸(5.64±4.40)比(3.34±1.84)μmol/L]、尿素(5.73±2.21)比(3.49±0.95)mmol/L]、肌酐(78.42±32.23)比(62.30±10.36)μmol/L]、尿酸(390.10±97.84)比(274.48±59.98)μmol/L]及β2-MG(3.42±1.21)比(2.19±0.44)mg/L]均高于正常妊娠组,差异有统计学意义(P<0.05);总蛋白(57.83±6.64)比(66.50±6.01)g/L]和白蛋白(28.33±3.87)比(33.40±2.82)g/L]均低于正常妊娠组,差异有统计学意义(P<0.05);重度子痫前期患者ALT、GGT和LDH异常者其妊娠结局较ALT、GGT和LDH正常者差。结论多项生化指标的变化可提示重度子痫前期的发生,ALT、GGT及LDH异常时提示重度子痫前期病情严重,可能出现不良围产儿结局。临床医生应重视这些指标的异常变化,并采取有效的干预措施,预防妊高征的发生与发展,改善围产儿结局。

Prediction of pregnancy outcomes in women with severe preeclampsia

Objective To explore the significance of each item of biochemical indices in women with severe preeclampsia.Methods Totally 115 cases of severe preeclampsia patients who were treated in the Third Affiliated Hospital of Zhengzhou University and 117 cases of normal pregnant women from June 2010 to December 2010 were reviewed.To compare alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyl transferase(GGT),total protein,albumin,bile acid,blood urea nitrogen,serum creatinine,uric acid and β2-microglobulin(β2-MG) between the two groups.Meantime,to observe the relation between the level of lactate dehydrogenase(LDH) and pregnancy outcomes in women with severe preeclampsia.Results ALT(22.36±24.44) vs(10.44±7.51)U/L],AST(31.08±27.23) vs(18.37±6.99)U/L],GGT(28.47±39.81) vs(10.79±7.50)U/L],bile acid(5.64±4.40) vs(3.34±1.84) μmol/L],blood urea nitrogen(5.73±2.21) vs(3.49±0.95) mmol/L],serum creatinine(78.42±32.23) vs(62.30±10.36) μmol/L],uric acid(390.10±97.84) vs(274.48±59.98) μmol/L] and β2-MG(3.42±1.21) vs(2.19±0.44) mg/L] in severe preeclampsia group were higher than those in control group,while total protein(57.83±6.64) vs(66.50±6.01) g/L] and albumin (28.33±3.87) vs(33.40±2.82) g/L] in severe preeclampsia group were lower than those in control group(P<0.05).In women with severe preeclampsia,the patients whose ALT,GGT or LDH is abnormal have worse pregnancy outcomes than those normal.Conclusions The change of biochemical indices may forecast severe preeclampsia.The increasing of ALT、GGT and LDH may result in bad perinatal outcomes.Doctors should pay much attention to them so that they can find the disease earlier and take effective measures to improve perinatal outcomes.