天津医药

天津医药 ›› 2023, Vol. 51 ›› Issue (2): 190-193.doi: 10.11958/20220717

• 临床研究 • 上一篇    下一篇

早产型子痫前期及慢性高血压并发子痫前期患者的临床特征及TyG指数对比研究

李晶(), 范卓然, 张俊农, 盛红娜, 华绍芳△()   

  1. 天津医科大学第二医院产科（邮编300211）
  • 收稿日期:2022-05-10 修回日期:2022-08-05 出版日期:2023-02-15 发布日期:2023-02-24
  • 通讯作者: △E-mail：hsf1974@126.com
  • 作者简介:李晶（1988），女，住院医师，主要从事产科疾病研究。E-mail：1329996739@qq.com
  • 基金资助:
    天津市卫生健康科技项目(ZC20057)

Comparative study on clinical characteristics and TyG index in patients with premature preeclampsia and chronic hypertension complicated with preeclampsia

LI Jing(), FAN Zhuoran, ZHANG Junnong, SHENG Hongna, HUA Shaofang△()   

  1. Department of Obstetrics, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
  • Received:2022-05-10 Revised:2022-08-05 Published:2023-02-15 Online:2023-02-24
  • Contact: △E-mail：hsf1974@126.com

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摘要：

目的 比较早产型子痫前期（PE）及慢性高血压并发PE患者的临床特点、围产结局及三酰甘油葡萄糖乘积指数（TyG指数）的差异。方法 选取158例因PE于孕28~36+6周行剖宫产终止妊娠的患者，根据是否合并慢性高血压分为慢性高血压PE组（53例）及PE组（105例），对2组患者的一般资料、血常规、凝血功能、生化指标、TyG指数等进行比较，并分析围产结局的差异。结果 与PE组比较，慢性高血压PE组年龄较大，孕期增重较多，分娩孕周更早（P<0.05）；慢性高血压PE组红细胞压积、血小板、纤维蛋白原、肌酸激酶同工酶、天冬氨酸转氨酶、总胆固醇、三酰甘油、空腹血糖、24 h尿蛋白定量均显著升高，而尿酸则偏低（P<0.05），该组还具有较高的TyG指数（9.89±0.30 vs. 9.76±0.26，P<0.01)。慢性高血压PE组的新生儿出生体质量、1分钟Apgar评分均较低，但其动脉血气碱剩余较高，NICU住院天数较长（P<0.05）。2组早产儿均以近足月早产（孕34~36+6周）占比最高，但慢性高血压PE组早期早产（孕28~31+6周）比例较高（28.3% vs. 10.5%），小于胎龄儿占比也较高（60.4% vs. 42.9%）。结论 早产型慢性高血压并发PE患者较早产型PE患者胰岛素抵抗、高凝状态、心肌及肾脏受损更加明显，早期早产及SGA风险更高，母胎监护应更加严密。

关键词: 子痫, 高血压, 早产, 子痫前期, TyG指数

Abstract:

Objective To study the clinical characteristics and perinatal outcomes of patients with premature preeclampsia (PE) and chronic hypertension complicated with PE, and to compare the difference of triglyceride-glucose index (TyG) between the two groups of patients. Methods A total of 158 cases of pregnancy terminated by cesarean section at 28-36+6 weeks of gestation due to "preeclampsia" were selected. According to whether they had chronic hypertension, patients were divided into the chronic hypertension PE group (53 cases) and the PE group (105 cases). The general data, blood routine, coagulation routine, biochemical indexes and TyG were compared between the two groups, and the difference in perinatal outcomes was analyzed. Results Compared with the PE group, patients in the chronic hypertension PE group had older age, higher gestational weight gain during pregnancy, and the gestational age of delivery is earlier, and the difference between the two groups was statistically significant (P<0.05). Data of hematocrit, platelet, fibrinogen, creatine kinase isoenzyme, aspartate aminotransferase, total cholesterol, triglyceride, fasting blood glucose and 24-hour urinary protein were significantly increased in the chronic hypertension PE group, while uric acid was lower (P<0.05). TyG index was also higher in the chronic hypertension PE group (9.89±0.30 vs. 9.76±0.26, P<0.01). The neonatal birth weight and 1-minute Apgar score were lower in the chronic hypertension PE group, but the arterial blood alkaloid surplus was higher and the length of hospital stay in NICU was longer (P<0.05). For both types of preterm PE, the preterm delivery near term (34-36+6 weeks of gestation) accounted for the largest proportion, but the early preterm birth (28-31+6 weeks of gestation) was higher in the chronic hypertension PE group (28.3% vs. 10.5%, P<0.01), and the proportion of small-gestational age babies (SGA) was also higher (60.4% vs. 42.9%，P<0.05). Conclusion Compared with preterm PE, patients with preterm chronic hypertension PE have more significant insulin resistance, hypercoagulability, myocardial and kidney damage, and higher risk of early preterm delivery and SGA. Maternal and fetal monitoring should be more intensive.

Key words: eclampsia, hypertension, premature birth, preeclampsia, TyG index

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