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目的探讨重度子痫前期(preeclampsia,PE)和妊娠期糖尿病(gestational diabetes mellitus,GDM)与妊娠晚期血浆同型半胱氨酸(homocysteine,Hcy)的关系。方法妊娠28~37周孕妇325例,其中重度PE患者105例为PE组,GDM患者120例为GDM组,正常晚期妊娠100例为对照组。采用循环酶法检测3组血浆Hcy水平,同时检测各组血清谷丙转氨酶(glutamic-pyruvic transaminase,GPT)、谷草转氨酶(glutamic-oxaloacetic transaminase,GOT)、肌酐(serum creatinine,SCr)、乳酸脱氢酶(lactate dehydrogenase,LDH)及血小板计数(platelet,PLT);采用Pearson线性相关分析Hcy与血清GPT、GOT、SCr、LDH及PLT的相关性。结果 PE组血浆Hcy水平[(11.29±4.26)μmol/L]高于GDM组[(5.15±2.90)μmol/L]和对照组[(3.83±1.68)μmol/L],GDM组高于对照组(P<0.05);PE组GPT[(67.43±57.82)u/L]、GOT[(48.83±59.90)u/L]、LDH[(411.17±370.99)u/L]高于GDM组[(20.86±10.25)u/L、(19.05±9.82)u/L、(148.81±56.81)u/L]和对照组[(18.56±11.71)u/L、(13.94±9.31)u/L、(127.05±36.44)u/L],PLT[(136.73±55.78)×109/L]低于GDM组[(188.14±43.31)×109/L]和对照组[(198.68±30.80)×109/L],差异均有统计学意义(P<0.05);Hcy与GPT(r=0.547,P=0.000)、GOT(r=0.432,P=0.000)及LDH(r=0.480,P=0.000)呈正相关,与PLT呈负相关(r=-0.357,P=0.000)。结论重度PE和GDM患者血浆Hcy水平可升高,血浆Hcy水平与疾病严重程度有相关性。
Objective To investigate the relationship between preeclampsia (PE) and gestational diabetes mellitus (GDM) and plasma homocysteine (Hcy) in late pregnancy. Methods Totally 325 pregnant women with gestational age from 28 to 37 weeks were enrolled. Among them, 105 cases of severe PE were PE group, 120 cases of GDM were GDM group and 100 cases of normal late pregnancy as control group. The levels of Hcy in plasma were detected by cyclic enzymology. Serum levels of glutamic-pyruvic transaminase (GPT), glutamic-oxaloacetic transaminase (GOT), serum creatinine (SCr) Lactate dehydrogenase (LDH) and platelet count (PLT). Pearson correlation was used to analyze the correlation between Hcy and serum GPT, GOT, SCr, LDH and PLT. Results The level of plasma Hcy in PE group [(11.29 ± 4.26) μmol / L] was significantly higher than that in GDM group [(5.15 ± 2.90) μmol / L and [3.83 ± 1.68] μmol / L] (48.83 ± 59.90) u / L] and LDH [(411.17 ± 370.99) u / L] in PE group were significantly higher than those in GDM group [(20.86 (18.56 ± 11.71) u / L, (13.94 ± 9.31) u / L, (12.05 ± 9.82) u / L, 36.44) u / L] and PLT [(136.73 ± 55.78) × 109 / L] were lower than those in the GDM group [(188.14 ± 43.31) × 109 / L] and the control group [(198.68 ± 30.80) × 109 / L] Hcy was positively correlated with GPT (r = 0.547, P = 0.000), GOT (r = 0.432, P = 0.000) and LDH (r = 0.480, P = 0.000) Was negatively correlated (r = -0.357, P = 0.000). Conclusions Plasma homocysteine levels can be increased in patients with severe PE and GDM, and plasma homocysteine levels correlate with the severity of the disease.