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目的:比较重度子痫前期孕妇与正常妊娠孕妇在不同孕期下血常规参数的变化并分析其临床意义。方法:选择重度子痫前期孕妇100例为观察组,正常妊娠孕妇100例为对照组,对两组孕妇从妊娠12周起每隔4周进行血常规检查,比较两组的参数变化。结果:观察组与对照组的白细胞计数(WBC)、中性粒细胞比例(N)、淋巴细胞比例(L)在不同孕周间变化不明显,差异没有统计学意义(P>0.05)。相同孕周下两组WBC、N、L的差异没有统计学意义(P>0.05)。对照组的红细胞计数(RBC)、血红蛋白浓度(Hb)、血细胞比容(HCT)在整个妊娠过程中表现出先降低后升高的趋势。观察组RBC、Hb和HCT在不同孕周下没有表现出先降低后升高的趋势。RBC和Hb水平在孕16～35周高于对照组的同期水平,HCT水平在孕20-31周高于对照组的同期水平,差异有统计学意义(P<0.05)。观察组与对照组血小板(PLT)水平在整个妊娠过程中均表现出缓慢下降的趋势,平均血小板体积(MPV)则呈现出逐步上升的趋势。观察组PLT在孕32～39周的水平低于同期对照组的水平,MPV在孕28～35周的水平高于同期对照组的水平,差异有统计学意义(P<0.05)。结论:血常规参数在不同孕周中的变化可以大致反映孕妇的血容量、血黏度以及凝血状态的变化。有望帮助临床早期筛选出重度子痫前期孕妇,及时给予针对性的干预以减轻症状、延缓病情发展。
Objective: To compare the changes of blood routine parameters in pregnant women with severe preeclampsia and normal pregnant women at different stages of pregnancy and to analyze their clinical significance. Methods: 100 pregnant women with severe preeclampsia were selected as the observation group and 100 normal pregnant women as the control group. The blood samples were taken from the 12th week of pregnancy to the 12th week of gestation. The parameters of the two groups were compared. Results: The WBC, neutrophil ratio (N) and lymphocyte ratio (L) in observation group and control group had no significant difference between different gestational weeks (P> 0.05). There was no significant difference in WBC, N and L in the same gestational weeks (P> 0.05). The RBC, Hb and HCT in the control group showed the first decrease and then the increase in the whole pregnancy. In observation group, RBC, Hb and HCT did not show the trend of decreasing first and then increasing in different gestational weeks. The levels of RBC and Hb were higher than those in the control group at 16-35 weeks of gestation, and HCT levels were higher than those in the control group at 20-31 weeks of gestation. The difference was statistically significant (P <0.05). The levels of platelet (PLT) in the observation group and the control group showed a slowly decreasing trend throughout the pregnancy, and mean platelet volume (MPV) showed a gradual upward trend. The level of PLT in the observation group was lower than that of the control group at 32-39th week of pregnancy, and the level of MPV in the 28-35th week of pregnancy was higher than that of the control group at the same period (P <0.05). Conclusion: The changes of blood parameters in different gestational weeks can roughly reflect the change of blood volume, blood viscosity and blood coagulation in pregnant women. Is expected to help early screening of pregnant women with severe preeclampsia, timely targeted interventions to reduce symptoms and delay the progression of the disease.