血清胱抑素C水平与早发型子痫前期发生和不良妊娠结局关系探讨

目的:研究孕妇发生早发型子痫前期及其出现不良妊娠结局与血清胱抑素C(CC)水平变化趋势关系。方法:选取2009年7月至2011年7月在南方医科大学南方医院妇产科住院治疗并分娩的早发型子痫前期患者69例,其中轻度15例(早发轻度组),重度54例(早发重度组),分析血清CC水平和子痫前期发生及母儿结局的关系。并同期选择产前检查正常的妊娠孕妇100例,检测其孕中期和孕晚期血清CC水平作为对照。结果:①正常妊娠孕妇孕中期和孕晚期时血清CC分别为0.81±0.12mmol/L和1.01±0.18mmol/L。早发轻度组血清CC(1.15±0.39mmol/L)和早发重度组血清CC(1.69±0.68mmol/L),分别与正常妊娠孕妇的孕中期和孕晚期比较,差异均有统计学意义(P<0.05)。②早发重度组的血清CC水平高于早发轻度组(P<0.05);早发重度组收缩压、舒张压、尿酸、肌酐和24小时尿蛋白水平均明显高于早发轻度组(P<0.05);早发重度组的羊水过少、胎儿生长受限、胎死宫内、低蛋白血症、胎盘早剥和HEELP综合征等不良妊娠的发生率高于早发轻度组。③早发重度组中出现不良妊娠结局患者中的CC水平高于未出现不良妊娠结局患者(P<0.05)。结论:子痫前期患者在妊娠中期血清CC水平已高于正常妊娠妇女,可能与子痫前期的发生和不良妊娠结局的出现相关。

Serum Cystatin C in Patients with Early-Onset Preeclampsia and Adverse Pregnant Outcomes

Objective:To investigate the relationship between the levels of serum Cystatin C(CC)and the early-onset preeclampsia and its adverse pregnant outcomes in pregnant women.Methods:A retrospective study was performed in 69 cases of pregnant women with early-onset preeclampsia in the obstetrical department of Nanfang Hospital from July 2009 to July 2011,in which 15 cases were mild preeclampsia (early-onset mild group)and 54 cases were severe preeclampsia(early-onset severe group).The relationship between serum CC level and genesis of preeclampsia and maternal-fetal outcomes was analyzed.100 normal pregnant women were selected as control group,in which the serum CC level was detected during the second and the third trimester.Results:①Level of Cystatin C in normal pregnant women in the second trimester and the third trimester were 0.81±0.12mmol/L,1.01±0.18mmol/L respectively.Cystatin C level in pregnant women with early-onset mild preeclampsia and early-onset severe preeclampsia were 1.15± 0.39mmol/L,1.69±0.68mmol/L respectively.There were statistical significant differences of serum Cystatin C level between normal pregnant women in the second and the third trimester and women with early-onset preeclampsia(P<0.05).②The level of Cystatin C in women with severe preeclampsia was significantly higher than those with mild preeclampsia(P<0.05).Compared with women with early-onset mild preeclampsia,women with early-onset severe preeclampsia had higher levels of systolic blood pressure, diastolic blood pressure,uric acid,creatinine and 24-hours urinary protein level(P<0.05);The preva-lence of oligohydramnios,fetal growth restriction,stillbirth,low serum protein,placental abruption and HELLP syndrome was higher in severe group than those with mild group(P<0.05).③In early onset severe preeclampsia,level of serum Cystatin C in women with adverse pregnant outcomes was significantly higher than those without adverse pregnancy outcomes(P<0.05).Conclusions:The serum CC level of preeclamptic women in the second trimester is higher than normal pregnant women,which is related to genesis of preeclampsia and adverse pregnant outcomes.