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目的探讨重度子痫前期(PE)产妇血清趋化因子配体10(CXCL10)和心肝肾功能指标的变化情况,并分析重度PE对妊娠结局的影响。方法选取2013年1月-2014年12月该院妇产科收治的重度PE孕妇33例为重度PE组,轻度PE孕妇31例为轻度PE组,另选取同期正常单胎妊娠孕妇37例为正常妊娠组,分析比较3组的血清CXCL10水平、心肝肾功能指标及妊娠结局情况。结果重度PE组和轻度PE组的血清CXCL10水平均明显高于正常妊娠组(P<0.05),但重度PE组和轻度PE组血清CXCL10水平比较差异无统计学意义(P>0.05)。重度PE组和轻度PE组左室射血分数(LVEF)明显低于正常妊娠组(P<0.05),心脏指数(CI)明显高于正常妊娠组(P<0.05);重度PE组LVEF低于轻度PE组(P<0.05),CI明显高于轻度PE组(P<0.05)。重度PE组谷丙转氨酶(ALT)明显高于正常妊娠组(P<0.05),重度PE组谷草转氨酶(AST)、碱性磷酸酶(ALP)、肌酐(Cre)、尿素氮(Bun)、尿酸(UA)均明显高于轻度PE组和正常妊娠组(P<0.05),轻度PE组ALP和UA明显高于正常妊娠组(P<0.05)。血清CXCL10水平与AST、ALP、Cre、UA呈正相关(rAST=0.403,rALP=0.347,rCre=0.271,rUA=0.286,P<0.05);重度PE组不良妊娠发生率明显高于轻度PE组和正常妊娠组(P<0.05),轻度PE组不良妊娠发生率明显高于正常妊娠组(P<0.05)。结论血清CXCL10水平增高可能与PE的发病及其相关的肝、肾功能损伤有关,随着PE病情的加重,不良妊娠结局的发生率明显升高。
Objective To investigate the changes of serum chemokine ligand 10 (CXCL10), cardiac, liver and kidney function in severe preeclampsia (PE) and to analyze the effect of severe PE on pregnancy outcome. Methods From January 2013 to December 2014, 33 cases of severe PE pregnant women admitted to obstetrics and gynecology department of our hospital were selected as severe PE group, 31 cases of mild PE group as mild PE group, and 37 cases of normal singleton pregnancy For the normal pregnancy group, the level of serum CXCL10, heart, liver and kidney function indexes and pregnancy outcome were analyzed and compared among the three groups. Results Serum levels of CXCL10 in severe PE group and mild PE group were significantly higher than those in normal pregnancy group (P <0.05). However, there was no significant difference in serum CXCL10 between severe PE group and mild PE group (P> 0.05). The left ventricular ejection fraction (LVEF) in severe PE group and mild PE group was significantly lower than that in normal pregnancy group (P <0.05), and the cardiac index (CI) was significantly higher than that in normal pregnancy group (P <0.05) In mild PE group (P <0.05), CI was significantly higher than mild PE group (P <0.05). Serum alanine aminotransferase (ALT) in severe PE group was significantly higher than that in normal pregnancy group (P <0.05). Serum alanine aminotransferase (AST), alkaline phosphatase (ALP), creatinine (CRE), urea, (P <0.05). The ALP and UA in mild PE group were significantly higher than those in normal pregnancy group (P <0.05). The serum level of CXCL10 was positively correlated with AST, ALP, Cre and UA (rAST = 0.403, rALP = 0.347, rCre = 0.271, rUA = 0.286, P <0.05). The incidence of adverse pregnancy in severe PE group was significantly higher than that in mild PE group In the normal pregnancy group (P <0.05), the incidence of adverse pregnancy in the mild PE group was significantly higher than that in the normal pregnancy group (P <0.05). Conclusion The elevated serum levels of CXCL10 may be related to the pathogenesis of PE and its related liver and renal dysfunction. With the exacerbation of PE, the incidence of adverse pregnancy outcomes is significantly increased.