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目的探讨妊娠高血压综合征孕妇围产期血浆D-二聚体(D-D)、T淋巴细胞亚群与C-反应蛋白(CRP)的动态变化及其相关性。方法选取妊高征孕妇120例,设为妊高征组;另选取健康孕妇60例,设为对照组。检测两组孕妇分娩前、分娩后第3d血浆D-D、CD3+及CD4+、CD8+T淋巴细胞亚群的百分率及CRP水平,并对妊高征孕妇血浆学指标进行相关性分析。结果对照组分娩前、分娩后第3d血浆D-D、T淋巴细胞亚群与CRP水平比较,差异均无统计学意义(P>0.05)。分娩前,妊高征组血浆D-D、CRP、CD4+/CD8+均高于对照组(P<0.01或P<0.05)。分娩后第3d,妊高征组中D-dimer、CRP则显著降低(P<0.05),CD4+/CD8+显著增加(P<0.05);但均高于对照组(P<0.05)。对妊高征组孕妇血浆学指标进行Pearson相关分析,显示血浆D-D、CRP、CD4+/CD8+指标间两两呈正相关(rD-D-CRP=0.62,rD-D-CD4+/CD8+=0.47,rCRP-CD4+/CD8+=0.52,P<0.01)。结论妊娠高血压综合征孕妇围产期血浆D-二聚体、T淋巴细胞亚群与C-反应蛋白水平较高,分娩前后均高于健康妊娠孕妇水平,且三指标间两两呈正相关,这提示妊娠高血压综合征的发生发展是多因素参与的复杂过程,其中免疫、炎症反应、血管内皮细胞损伤、凝血/纤溶系统活性失衡等病理过程可能是同步发生且相互影响的。
Objective To investigate the dynamic changes of perinatal plasma D-D, T lymphocyte subsets and C-reactive protein (CRP) in pregnancy induced hypertension syndrome and its relationship. Methods Select pregnant women with PIH 120 cases, set for pregnancy induced hypertension group; another healthy pregnant women selected 60 cases, as the control group. The percentages of plasma D-D, CD3 +, CD4 +, CD8 + T lymphocyte subsets and CRP levels on the third day after childbirth in the two groups were measured. The correlation between the plasma levels and the plasma levels of pregnant women with PIH was analyzed. Results There was no significant difference in D-D, T lymphocyte subsets and CRP levels between the control group before delivery and the third day after delivery (P> 0.05). Before delivery, plasma D-D, CRP, CD4 + / CD8 + in PIH group were higher than those in control group (P <0.01 or P <0.05). The levels of D-dimer and CRP in PIH group decreased significantly (P <0.05) and CD4 + / CD8 + increased significantly (P <0.05) on the 3rd day after childbirth, but both were higher than those in control group (P <0.05). Pearson correlation analysis showed that plasma DD, CRP and CD4 + / CD8 + were positively correlated with each other (rD-D-CRP = 0.62, rD-D-CD4 + / CD8 + = 0.47, rCRP- CD4 + / CD8 + = 0.52, P <0.01). Conclusions The levels of plasma D-dimer, T lymphocyte subsets and C-reactive protein in perinatal patients with gestational hypertension syndrome are higher than those of healthy pregnant women before and after delivery, and there is a positive correlation between the three indexes. This suggests that the occurrence and development of pregnancy-induced hypertension syndrome is a complex process involving many factors. Pathological processes such as immune, inflammatory reaction, vascular endothelial cell injury, and imbalance of coagulation / fibrinolysis system activity may occur synchronously and interact with each other.