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目的:1前瞻性观察妊娠12周、24周、36周、产后48h血浆内皮素、血液流变学指标在妊高征发病过程中的演变规律。2探讨上述两指标与妊高征的相关性及其预测价值。方法:对104例正常初孕妇,在孕12周、24周、36周及产后48h分别测定血浆内皮素(ET)、血液流变学参数(全血粘度、血浆粘度、红细胞比积、纤维蛋白原、血沉),并随访其妊娠结局。结果:1妊娠结局:104例孕妇中发生妊高征30例(妊高征组),无合并症的正常妊娠妇女74例(正常妊娠组)。2正常妊娠妇女血浆ET水平随孕周增加呈不同程度增长趋势,高峰出现在孕36周前后,产后48h开始明显下降。3妊高征组血浆ET水平在各孕周均显著高于正常妊娠组(P<0.01),尤其孕36周升高水平是正常妊娠组测定值的2倍。4ET与血液流变学水平在妊高征患者中的变化趋势一致,但无明显相关(P>0.05)。5以ET≥78.29pg/L为最佳切点预测妊高征的发生机率。孕12周时应用该检验值误诊率仅12.16%,半数以上患者可早期发现,到妊娠晚期,占96.97%的正常孕妇ET值均低于该指标之下。结论:内皮素在正常妊娠妇女中,预测妊高征的临床价值较好。最佳切点为ET≥78.29pg/L。
PURPOSE: To prospectively observe the evolution of plasma endothelin and hemorheology in pregnancy induced hypertension during 12 weeks, 24 weeks, 36 weeks and 48 hours postpartum. 2 to explore the above two indicators and pregnancy-induced hypertension correlation and its predictive value. Methods: The plasma levels of endothelin (ET), blood rheological parameters (whole blood viscosity, plasma viscosity, hematocrit, fibrin Original, ESR), and follow-up of their pregnancy outcome. Results: 1 pregnancy outcome: pregnancy induced hypertension in 104 cases of pregnant women in 30 cases (PIH group), no complications of 74 normal pregnant women (normal pregnancy group). The levels of plasma ET in normal pregnant women increased with different gestational ages, the peak appeared at around 36 weeks of pregnancy, and decreased significantly at 48 hours postpartum. 3 Plasma ET level in PIH group was significantly higher than that in normal pregnancy group (P <0.01), especially in 36 weeks pregnant group, which was twice as high as that in normal pregnancy group. The trend of 4ET and hemorheology in patients with PIH was the same, but there was no significant correlation (P> 0.05). 5 to ET ≥ 78.29pg / L as the best cut point to predict the incidence of pregnancy-induced hypertension. At 12 weeks of pregnancy, the misdiagnosis rate of this test was only 12.16%. More than half of the patients could be detected early. By the third trimester of pregnancy, the ET value of 96.97% of normal pregnant women was lower than this index. Conclusion: Endothelin in normal pregnancy women, predict the clinical value of pregnancy-induced hypertension is better. The best cut point for the ET ≥ 78.29pg / L.