摘要
目的分析重度子痫前期(severe preeclampsia,SPE)并发溶血肝功能异常血小板减少(hemolysis,elevated liver function and low platelet count,HELLP)综合征炎症指标的变化及危险因素。方法采用回顾性研究方法,选取2012年1月至2021年12月温州市中西医结合医院收治的SPE患者52例,根据是否并发HELLP综合征将其分为观察组(n=20)和对照组(n=32)。观察组患者并发HELLP综合征,对照组无HELLP综合征。检测两组患者的白细胞计数(white blood cell,WBC)、中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白细胞介素-6(interleukin-6,IL-6)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)等炎症指标。采用t检验或Mann-Whitney U检验对数据进行比较,SPE并发HELLP综合征的影响因素评价采用多因素Logistic回归分析。结果观察组患者的WBC、NLR、hs-CRP、IL-6及TNF-α水平均高于对照组[(12.0±3.3)×10^(9)/L vs(9.3±2.4)×10^(9)/L,t=3.413;(5.43±1.67)vs(4.27±1.27),t=2.347;31.10(1.13~88.93)mg/L vs 5.38(0.50~17.99)mg/L,Z=-4.806;8.8(3.4~14.5)pg/ml vs 6.6(2.7~10.2)pg/ml,Z=-2.136;8.4(6.0~10.9)pg/ml vs 5.8(2.1~9.7)pg/ml,Z=-4.177],差异均有统计学意义(P<0.05)。观察组患者的IL-4及IL-10水平均低于对照组[(2.41±0.65)pg/ml vs(3.00±0.92)pg/ml,t=-2.505;(2.37±0.63)pg/ml vs(3.24±0.76)pg/ml,t=-4.291],差异均有统计学意义(P<0.05)。多因素Logistic回归分析发现,WBC、NLR、hs-CRP、IL-6及TNF-α水平的升高及IL-10水平的降低是SPE并发HELLP综合征的部分危险因素[校正后OR值(95%CI)分别为1.435(1.108~1.859)、1.466(1.034~2.078)、1.283(1.082~1.523)、1.317(1.029~1.686)、2.538(1.420~4.535)和6.663(1.912~23.004),P均<0.05]。结论在SPE患者中,WBC、NLR、hs-CRP、IL-6和TNF-α水平的升高及IL-10水平的降低可能是并发HELLP综合征的部分危险因素。
Objective To explore the changes of inflammatory markers of severe preeclampsia complicated with hemolysis,elevated liver function and low platelet count(HELLP)syndrome.Methods A total of 52 severe pre-eclampsia cases were enrolled from January 2012 to Decemer 2021 by retrospective study.A retrospective study method was used to select 52 SPE patients admitted to Combination of Traditional Chinese Medicine with Western Medicine Hospital from January 2012 to December 2021,and they were divided into observation group(20 cases)and control group(32 cases)according to whether or not complicated with HELLP syndrome.The patients of observation group was complicated with HELLP syndrome,while the patients of control group was not complicated with HELLP syndrome.The white blood cell(WBC),neutrophil-to-lymphocyte ratio(NLR),hypersensitive C reactive protein(hs-CRP),inflammatory indicators such as interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected.T-test and Mann-Whitney U test were used for data comparison.Multivariate logistic regression analysis was used to evaluate the influencing factors of SPE complicated with HELLP syndrome.Results The levels of WBC,NLR,hs-CRP,IL-6 and TNF-αin observation group were higher than those in control group[(12.0±3.3)×10^(9)/L vs(9.3±2.4)×10^(9)/L,t=3.413;(5.43±1.67)vs(4.27±1.27),t=2.347;31.10(1.13-88.93)vs 5.38(0.50-17.99)mg/L,Z=-4.806;8.8(3.4-14.5)pg/ml vs 6.6(2.7-10.2)pg/ml,Z=-2.136;8.4(6.0-10.9)pg/ml vs 5.8(2.1-9.7)pg/ml,Z=-4.177],the differences were statistically significant(P<0.05).Levels of IL-4 and IL-10 in observation group were lower than those in control group[(2.41±0.65)pg/ml vs(3.00±0.92)pg/ml,t=-2.505;(2.37±0.63)pg/ml vs(3.24±0.76)pg/ml,t=-4.291],the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that elevated levels of WBC,NLR,hs-CRP,IL-6,TNF-αand descendant level of IL-10 were partial risk factors for HELLP syndrome[Adjusted OR(95%CI):1.435(1.108-1.859),1.466(1.034-2.078),1.283(1.082-1.523),1.3
作者
吴丽群
高洁
姚锐
王美霞
许群
WU Liqun;GAO Jie;YAO Rui;WANG Meixia;XU Qun(Department of Obstetrics and Gynecology,Wenzhou Combination of Traditional Chinese Medicine with Western Medicine Hospital,Zhejiang,Wenzhou 325000,China)
出处
《中国现代医生》
2022年第27期33-37,共5页
China Modern Doctor
