Hypertension:乳酸脱氢酶水平升高或可作为重度子娴前期的特征

2018-06-26 MedSci MedSci原创

溶血可导致不良妊娠结局。目前,除了溶血、肝酶升高和低血小板计数综合征以外,关于妊娠期高血压疾病的其他溶血数据仍很匮乏。为评估溶血在妊娠期高血压疾病中的发生率和影响,Richard M. Burwick等人,于2013年10月-2017年5月在一单独中心针对采用乳酸脱氢酶(LDH)水平筛查溶血的女性中进行一回顾性队列研究,将LDH水平与高血压病(慢性高血压、妊娠期高血压、子娴前期和伴有严重症状的子娴

溶血可导致不良妊娠结局。目前,除了溶血、肝酶升高和低血小板计数综合征以外,关于妊娠期高血压疾病的其他溶血数据仍很匮乏。为评估溶血在妊娠期高血压疾病中的发生率和影响,Richard M. Burwick等人,于2013年10月-2017年5月在一单独中心针对采用乳酸脱氢酶(LDH)水平筛查溶血的女性中进行一回顾性队列研究,将LDH水平与高血压病(慢性高血压、妊娠期高血压、子娴前期和伴有严重症状的子娴前期)进行对比,并评估其对不良妊娠结局的影响。

在8645位分娩女性中,1188位(13.7%)患有高血压病。其中,812位(68.4%)在分娩前进行了LDH检测:慢性高血压 152位、妊娠期高血压 209位、子娴前期 216位、伴有严重症状的子娴前期 235位。LDH≥400U/L(≥1.6倍正常值)在伴有严重症状的子娴前期女性中比在其他妊娠期高血压病女性中更常见(9.8% vs 2.3%;p<0.001),校正优势比 4.52(95% CI 2.2-9.2;p<0.001)。LDH≥400U/L与产妇不良结局相关(41.7% vs 15.3%;p<0.001),校正优势比 3.05(95% VI 1.4-6.7;p=0.006);同时还与新生儿不良结局相关(如早产 59.4% vs 22.5%;p<0.001)。研究人员发现LDH水平升高与高血压和子娴前期的产妇和新生儿不良预后相关,与溶血、肝酶升高和低血小板计数综合征无关。

总而言之,LHD水平升高(≥1.6倍正常值或LDH≥400U/L)或许是重度子痫前期的特征。

原始出处:

Richard M. Burwick,et al. Evaluation of Hemolysis as a Severe Feature of Preeclampsia. Hypertension. June 25,2018. https://doi.org/10.1161/HYPERTENSIONAHA.118.11211


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    2018-12-31 feather89
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    2018-07-01 虈亣靌

    学习了.学习了.学习了

    0

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    2018-06-26 虈亣靌

    认真学习.把间接经验应用到临床实践中去.然后再总结出新思路.给点赞啦

    0

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