孕中期体水分及凝血四项在妊娠期高血压患者中的水平变化及危险因素分析OA
Analysis of changes in maternal body water and four blood coagulation parameters and risk factors in patients with gestational hypertension during the second trimester pregnancy
目的 对妊娠期高血压患者孕中期体水分及凝血四项水平的变化进行分析,并探讨其相关的危险因素.方法 选取合肥市妇幼保健院 2021 年 3 月至 2024 年 3 月期间收治的 90 例妊娠期高血压患者作为观察组,同期选取 45 例孕中期健康孕妇为对照组,观察组按照妊娠期高血压症状分级标准分为轻度组 27 例、中度组 38 例及高度组 25 例.测定所有研究对象孕中期体水分[总水分(TBW)、细胞外水分(ECW)、细胞内水分(ICW)、骨骼肌质量(SMM)、体脂肪含量(BFM)]及凝血四项[D-二聚体(D-D)、纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]水平,并通过多因素 Logistic 回归分析探讨影响妊娠期高血压的独立危险因素.结果 对照组、轻度组、中度组与高度组 TBW、ECW、ICW、SMM、BFM、FIB、D-D 水平均依次升高,APTT、PT 水平均依次降低,差异有统计学意义(F 值介于 18.190～584.240 之间,P<0.05);与对照组相比,观察组年龄≥35岁、孕前 BMI≥24 kg/m2、有高血压家族史占比较高,差异有统计学意义(χ2 值介于 14.466～24.068 之间,P<0.05);多因素Logistic 回归分析结果显示,年龄较大、孕前 BMI 较高、有高血压病家族史,以及高水平 TBW、ECW、ICW、SMM、BFM、D-D、FIB是妊娠期高血压发生的 危 险 因 素(OR 值介于 1.429～2.972 之间,P<0.05),高水平 PT、APTT 是保护因素(OR 值分别为0.819、0.738,P<0.05).结论 TBW、ECW、ICW、SMM、BFM、FIB、D-D 水平在妊娠期高血压患者中表达较高,APTT、PT 水平表达较低,其与妊娠期高血压的发生密切相关.
Objective To analyze the changes in body water and four blood coagulation parameters in pregnant women with gestational hypertension during the second trimester,and to explore the related risk factors.Methods 90 pregnant women with gestational hypertension admitted to Hefei maternal and child health hospital from March 2021 to March 2024 were selected as the observation group,and 45 healthy pregnant women in the second trimester were selected as the control group.The observation group was divided into mild group(27 cases),moderate group(38 cases),and high group(25 cases)according to the gestational hypertension symptom grading standard.The levels of body water[total body water(TBW),extra cellular water(ECW),intra cellular water(ICW),skeletal muscle mass(SMM),body fat mass(BFM)]and four blood coagulation parameters[D-dimer(D-D),fibrinogen(FIB),prothrombin time(PT),activated partial thromboplastin time(APTT)]of all study subjects were measured.Multivariate Logistic regression analysis was used to explore the independent risk factors affecting gestational hypertension.Results The levels of TBW,ECW,ICW,SMM,BFM,FIB,D-D in the control group,mild group,moderate group and high group successively increased,while the levels of APTT and PT successively decreased,and the differences were statistically significant(F values ranging from 18.190 to 584.240,P<0.05).Compared with the control group,the proportions of older age(≥35 years),pre-pregnancy BMI≥24 kg/m2,and having a history of hypertension in the observation group were higher,and the differences were statistically significant(χ2 values ranging from 14.466 to 24.068,P<0.05).The results of multivariate Logistic regression analysis showed that older age,higher pre-pregnancy BMI,having a history of hypertension,high levels of TBW,ECW,ICW,SMM,BFM,D-D,FIB were risk factors for gestational hypertension(OR values ranging from 1.429 to 2.972,P<0.05),while high levels of PT and APTT were protective factors(OR values were 0.819 and 0.738,respectively,P<0.05).Conclusion The levels of TBW,ECW,ICW,SMM,BFM,FIB,D-D were higher in pregnant women with gestational hypertension,while the levels of APTT and PT were lower.These parameters are closely related to the occurrence of gestational hypertension.
金艳;张静;张军辉
合肥市妇幼保健院妇产科,安徽 合肥 230000合肥市妇幼保健院妇产科,安徽 合肥 230000合肥市妇幼保健院妇产科,安徽 合肥 230000
医药卫生
妊娠期高血压孕中期母体水分凝血四项危险因素
gestational hypertensionsecond trimestermaternal body waterfour blood coagulation parametersrisk factor
《中国妇幼健康研究》 2026 (9)
1-6,6
安徽省自然科学基金项目(2308085MC83)
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