国际妇产科学杂志

国际妇产科学杂志 ›› 2017, Vol. 44 ›› Issue (5): 565-568.

• 论著 • 上一篇    下一篇

妊娠期高血压疾病患者血浆D-二聚体与亮氨酸氨基肽酶的关系

叶桂云,池细俤,朱家瑞,黄远茂,陈莉青,李文燕   

  1. 353000  福建省南平市，福建医科大学附属南平第一医院检验科
  • 收稿日期:2017-07-11 修回日期:2017-09-21 出版日期:2017-10-15 发布日期:2017-10-25

Relationship of Plasma D-dimer and Leucine Aminopeptidase in Hypertensive Disorders Complicating Pregnancy

YE Gui-yun，CHI Xi-di，ZHU Jia-rui，HUANG Yuan-mao，CHEN Li-qing，LI Wen-yan   

  1. Department of Laboratery Medical，Fujian Medical University Affiliated Nanping First Hospital，Nanping 353000，Fujian Province，China
  • Received:2017-07-11 Revised:2017-09-21 Published:2017-10-15 Online:2017-10-25

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摘要： 目的：探讨妊娠期高血压疾病（hypertensive disorders complicating pregnancy，HDCP）患者血浆D-二聚体与亮氨酸氨基肽酶（leucine aminopeptidase，LAP）的关系以及临床上的应用价值。方法：选取2015年8月—2016年12月在南平市第一医院产检正常的妊娠妇女404例，经体检未孕健康妇女101例。选取同期在南平市第一医院收治的HDCP妇女116例。检测受试者LAP、碱性磷酸酶（ALP）、D-二聚体﹑尿总蛋白、尿肌酐等，计算尿总蛋白肌酐比（UTPCR）。采用单因素方差分析、Pearson相关分析和趋势图分析D-二聚体与LAP、UTPCR等的关系。结果：HDCP组患者收缩压、D-二聚体浓度和UTPCR高于非妊娠期组和正常妊娠各期组，差异有统计学意义（均P＜0.05），LAP浓度低于妊娠晚期组（P＜0.05）。妊娠晚期组的D-二聚体浓度仅与UTPCR值呈正相关（r=0.190，P=0.011）。HDCP组患者D-二聚体浓度与孕周和LAP浓度呈负相关（r=-0.505，P=0.000；r=-0.443，P=0.001），与UTPCR值呈正相关（r=0.372，P=0.004）。趋势图显示HDCP组患者血浆D-二聚体浓度高于正常妊娠晚期妇女，血浆LAP浓度低于正常妊娠晚期妇女。结论：HDCP患者血浆D-二聚体与LAP相关性较好，联合检测D-二聚体和LAP，结合UTPCR对HDCP早期发现、治疗及预防有重要临床价值。

关键词: 高血压, 妊娠性, D-二聚体, 亮氨酸氨基肽酶, 尿总蛋白肌酐比

Abstract: Objective：To investigate the relationship and the application value of plasma D-dimer and leucine aminopeptidase (LAP) in the hypertensive disorders complicating pregnancy (HDCP). Methods：A number of 404 healthy  pregnant women and 101 healthy non-pregnant women were enrolled from the obstetrical examination department of Fujian Medical University Affiliated Nanping First Hospital from August 2015 to December 2016, and a total of 116 HDCP were enrolled from the Obstetrics and Gynecology Department of Nanping First Hospital from August 2015 to December 2016. LAP, alkaline phosphatase (ALP), plasma D-dimer, urine total protein and urine creatinine of all the subjects were detected, and value of urinary total protein/creatinine ratio (UTPCR) was calculated. Single factor analysis of variance, Pearson correlation analysis and Trend chart were performed to test the relationship between plasma D-dimer and LAP, UTPCR. Results：Compared with the healthy non-pregnant women and various stages of healthy pregnant women, systolic blood pressure, D-dimer, UTPCR of HDCP were significantly higher (P<0.05), and LAP of HDCP significantly lower than that of late healthy pregnancy period (P<0.05). Correlation analysis showed that D-dimer of late healthy pregnancy women was only related to urinary protein (r=0.19, P=0.011), D-dimer of HDCP was strongly correlated to gestational period (r=-0.505, P=0.000), LAP (r=-0.443, P=0.001), UTPCR (r=0.372, P=0.004). Trend graph showed that D-dimer level of HDCP was significantly higher than that of the corresponding period of healthy pregnant women, and LAP level of HDCP was obviously lower. Conclusions：Plasma D-dimer is preferably related to LAP in HDCP, and plasma D-dimer, LAP and UTPCR are the important basises for early detection, treatment and prevention for HDCP.

Key words: Hypertension, pregnancy-induced, D-dimer, Leucine aminopeptidase, Urinary total protein/creatinine ratio