Correlation Analysis Of Pregnant Women’s Blood Coagulation,inflammatory Cells And Other Indexes With Hypertension During Pregnancy

Background and ObjectiveHypertension during pregnancy(HDP)is a common group of high risk complications in obstetrics.Its etiology is complex and disease is changeable,and it is closely related to the adverse pregnancy outcomes such as premature birth,abortion,placental abruption,premature rupture of membranes,fetal deformity and low birth weight of newborn,which seriously threatens the health and safety of mothers and babies.At present,it is believed that the occurrence of hypertension during pregnancy is mainly related to the insufficient recast of the uterine spiral artery,the over-activated immune response,and the vascular endothelial dysfunction,but its etiology and specific pathogenesis are still unclear.HDP involves multiple organ injuries,among which renal injury is the most common and obvious one,and impair of renal function can lead to proteinuria,qualitatively and quantitatively determination of urinary protein has always been one of the diagnostic criteria for the progression of gestational hypertension to preeclampsia(PE),as well as an important auxiliary indicator for judging the severity of the condition.However,the qualitative determination of urinary protein,the determination of urinary protein and the measurement of blood pressure have some disadvantages in the diagnosis of HDP at present,therefore,we need to strengthen the research on other simple and sensitive biological indicators that have predictive value for the progression of pregnancy hypertension disease.This research mainly through the analysis of hypertension during pregnancy in pregnant women blood clotting,and inflammatory cells and unconjugated estriol blood index level change and its correlation with the urine protein,further to explore whether the index changes of hypertension during pregnancy progression potential predictive value,for the early diagnosis of hypertension during pregnancy and provide certain clinical auxiliary function condition monitoring,to improve maternal and child has very important significance adverse pregnancy outcomes.MethodsA total of 722 pregnant women with hypertension during pregnancy who were diagnosed and delivered in the Third Affiliated Hospital of Zhengzhou University from January 2018 to January 2019 were selected as the study group,and 817 normal pregnant women who delivered in the hospital during the same period were selected as the control group.A total of 722 pregnant women with hypertension during pregnancy were divided into three groups: urinary protein-～+-group(n = 220),1+ group(n = 98),2+ group(n = 152)and ≥3+ group(n = 252).General data and laboratory data of pregnant women in each group were collected,including systolic blood pressure,diastolic blood pressure,body mass index(BMI),number of births,age,and previous medical history.Laboratory data: maternal urine protein qualitative index,platelet(PLT),platelet packed volume(PCT),mean platelet volume(MPV),D-dimer(D-D),hemoglobin(HB),hematocrit(HCT),variation in red blood cell distribution width(RDW-CV),aspartic acid aminotransferase(AST),alanine aminotransferase(ALT),total protein(TP),unconjugated estriol(u E3)in Down’s screening during the second trimester of pregnancy,neutrophilic granulocyte percentage(Neu %),C-reactive protein(CRP),white blood cell(WBC)etc,among them,the neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)were calculated according to the ratio of the counts of various inflammatory cells in blood routine,the concentration value of unconjugated estriol was converted into a median multiple value(MOM value)to represent(transformation formula: MOM = test value/same median value of gestational age).Retrospective analysis was used to conduct statistical research on the data.According to the diagnostic criteria of hypertension during pregnancy,the average of the three highest values of pregnant women’s blood pressure in the calm state before delivery was taken.In this study,the differences in inflammatory cells,hemagglutination and unconjugated estriol levels between the study group and the control group were firstly analyzed;then the change of each index level in different groups of urinary protein and its correlation with the severity of urinary protein were analyzed;finally,the correlation between plasma D-D and u E3 and TP was further investigated.Statistical AnalysisAll data were analyzed by SPSS25.0 statistical software.Measurement data were expressed as mean ± standard deviation((?)±s),and t-test was used for comparison between the two groups;one-way ANOVA was used to compare the measurement data of two or more groups,Levene test was used for homogeneity of variance,GamesHowell test was used for pair comparison between all groups when variances were not homogenous,Tukey-Kramer test was used for pair comparison between all groups when variances were homogenous,and P<0.05 was statistically significant;Kendall’s Tau-B correlation coefficient test was used for correlation analysis,and P < 0.01 showed significant correlation.Results1.The levels of PLT,PCT,PLR,TP,HCT,HB and u E3 Mo M in peripheral blood of pregnant women in the study group were significantly lower than those in the control group,while the levels of D-D,CRP,NEU,WBC,NLR,AST,ALT and RDW-CV in the study group were higher than those in the control group,with statistical significance(P < 0.05).There was no significant difference in the blood MPV level between the study group and the control group(P > 0.05);2.The levels of PLT,PCT,PLR,TP,HCT,HB and u E3 Mo M in peripheral blood of pregnant women in the study group showed a decreasing trend with the aggravation of urinary protein in HDP pregnant women,while the levels of D-D,CRP,NEU,WBC,NLR,AST and ALT showed an increasing trend with the aggravation of urinary protein in HDP pregnant women,with statistical significance between groups(P < 0.05).There was no significant difference in RDW-CV among different urinary protein groups(P >0.05);3.Plasma CRP,ALT,D-D,NLR,WBC,AST,NEU were positively correlated with urinary protein indexes(P < 0.01),and the correlation coefficients were 0.703,0.675,0.633,0.587,0.475,0.424,0.207,respectively;PLR,TP,PLT,PCT,HB,u E3 MOM and HCT in peripheral blood were negatively correlated with urinary protein level(P < 0.01),and the correlation coefficients were-0.682,-0.642,-0.443,-0.428,-0.407,0.347,0.137,respectively;there was a strong positive correlation between CRP and urinary protein level,and a strong negative correlation between PLR level and urinary protein level.4.The levels of TP and u E3 Mo M in the study group were negatively correlated with the levels of D-D in plasma(P < 0.01),and the correlation coefficients were-0.437 and-0.558,respectively.Conclusions1.Plasma levels of CRP,ALT,D-D,AST,NLR,WBC and NEU were positively correlated with urinary protein indexes in pregnant women with HDP,and the correlation between CRP and urinary protein indexes was stronger,which had certain auxiliary diagnostic value for the evaluation of HDP disease condition;2.Serum PLR,TP,PLT,PCT,Hb,u E3 MOM and HCT were all negatively correlated with the levels of urinary protein in HDP pregnant women,and PLR was strongly correlated with the levels of urinary protein,which had a good predictive value for the disease progression of HDP;3.The levels of TP and u E3 MOM in the blood of pregnant women with HDP were significantly correlated with plasma D-D,which provided a clinical basis for further exploring the mechanism of the effect of D-D on the condition of pregnant women with HDP.