河北医科大学学报

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妊娠期高血压疾病对新生儿凝血功能、NSE及PCT水平的影响

  

  1. 1.河北省石家庄市妇幼保健院妇产科，河北 石家庄 050051；2.河北省石家庄市妇幼保健院产前诊断中心，
    河北 石家庄 050051；3.河北省邯郸市第一医院妇产科，河北 邯郸 056002；
    4.河北省石家庄市妇幼保健院检验科，河北 石家庄  050051
  • 出版日期:2020-03-25 发布日期:2020-04-02
  • 作者简介:崔照领(1978-)，女，河北沧州人，河北省石家庄市第六医院副主任医师，医学硕士，从事产科疾病诊治研究。
  • 基金资助:
    河北省医学科学研究重点课题（20160347）

Effect of hypertensive disorder during pregnancy on coagulation function, NSE and PCT levels in neonates

  1. 1.Department of Obstetrics and Gynaecology, the Maternal and Child Health Hospital of Shijiazhuang
    Municipal, Hebei Province, Shijiazhuang 050051, China； 2.Department of Prenatal Diagnosis Center, 
    the Maternal and Child Health Hospital of Shijiazhuang, Hebei Province, Shijiazhuang 050051,China；
    3.Department of Obstetrics and Gynaecology, First Hospital of Handan, Hebei Province, Handan
    056002,China； 4.Department of Laboratory,  the Maternal and Child Health Hospital of
    Shijiazhuang Municipal, Hebei Province, Shijiazhuang 050051, China
  • Online:2020-03-25 Published:2020-04-02

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摘要： ［摘要］
目的  探讨妊娠期高血压疾病（hypertensive disorder complicating pregnancy，HDCP）对新生儿凝血功能、神经元特异性烯醇化酶（neuron-specific enolase，NSE）及降钙素原（procalcitonin，PCT）水平的影响。
方法  以重症监护病房（intensive care unit，ICU）收治的HDCP患者分娩的新生儿592例为观察对象，并根据产妇病情严重情况将新生儿分为3组：A组（重度子痫前期，112例）、B组（轻度子痫前期，197例）、C组（HDCP，283例），选取同期未患有HCDP的产妇所分娩的新生儿500例为对照组。于生后2 h检测各组新生儿凝血功能指标［凝血酶原时间（prothrombin time，PT）、活化部分凝血激酶时间（activated partial thromboplastin time，APTT）、纤维素原（fibrinogen，FIB）、D-二聚体（D dimer，D-D）、血小板计数（platelet count，PLT）、纤维蛋白原降解产物（fibrinogen degradation product，FDP）］、NSE及PCT水平，并进行组间比较。分析各指标与HDCP病情严重程度的相关性。
结果  A、B、C及对照组中各指标水平比较差异均有统计学意义（P＜0.01）。相关性分析结果显示，PT、APTT、D-D、FDP、PCT及NSE水平与HDCP病情严重程度呈正相关，而FIB、PLT水平与HDCP病情严重程度呈负相关（P＜0.05或P＜0.01）。
结论  HDCP易导致新生儿凝血功能障碍，使新生儿血液处于低凝和继发性纤溶亢进的状态，并增加新生儿脑损伤及感染发生风险。孕妇病情越严重，新生儿越易导致凝血功能障碍及脑损伤。

关键词: 高血压, 妊娠性, 降钙素, 磷酸丙酮酸水合酶

Abstract: ［Abstract］ ObjectiveTo investigate the effects of hypertensive disorder complicating hypertension(HDCP) on neonatal coagulation, neuron specific enolase(NSE) and procalcitonin(PCT) levels.
〖WTHZ〗MethodsA total of 592 neonates born from HDCP patients admitted to our intensive care unit(ICU) were enrolled in the study. The newborns were divided into three groups according to the serious condition of the maternal condition: group A(112 cases with severe pre-eclampsia), group B(197 cases with mild pre-eclampsia), group C(HDCP, 283 cases), 500 cases of neonates born from women who did not have HCDP at the same time were selected as the control group. The coagulation function indexes［prothrombin time(PT）, activated partial thromboplastin time（APTT）, fibrinogen（FIB）, D dimer（D-D）, platelet count（PLT）, fibrinogen degradation product（FDP)］, NSE and PCT levels of each group were measured at 2 h after birth, and comparison between groups was performed. Spearman correlation method was used to analyze the correlation between each index and the severity of HDCP.
〖WTHZ〗Results The differences of the indexes of A, B, C and the control group were statistically significant(P＜0.01). Correlation analysis showed that the levels of PT, APTT, D-D, FDP, PCT and NSE were positively correlated with the severity of HDCP, while the levels of FIB and PLT were negatively correlated with the severity of HDCP(P＜0.05 or P＜0.01).
〖WTHZ〗ConclusionPregnancy-induced hypertension can easily lead to neonatal coagulopathy, which makes neonatal blood in a state of hypocoagulability and secondary fibrinolysis, and increases the risk of neonatal brain injury and infection. The more severe the maternal condition, the more likely the neonatal will cause coagulopathy and brain damage.

Key words: hypertension, pregnancy-induced, calcitonin, phosphopyruvate hydratase

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