Study On The Relationship Between Inflammation And Coagulation In Hypertensive Disorder Complicating Pregnancy

Objective:To analyze the differences and correlation between the inflammatory indexes,coagulation indexes and various indexes of thromboelastogram(TEG)in peripheral blood of patients with hypertensive disorders complicating pregnancy(HDCP)and normal pregnant women.In order to explore the relationship between inflammation and blood hypercoagulability in patients with HDCP,predict the coagulation status of HDCP patients,and provide guidance for the prevention and treatment of thrombosis risk in HDCP patients.Methods:The medical records of expectant mothers who were hospitalized for delivery in the obstetrics department of Taiyuan Central Hospital from March 1,2020 to March 1,2021 were collected.According to the inclusion and exclusion criteria,31 patients with HDCP were selected as the HDCP group,and 72 patients with normal pregnancy were selected as the normal pregnancy group.The difference and correlation between inflammation related indexes(Leukocyte count(WBC),Neutrophil count(NEU),Lymphocyte count(LYM),Monocyte count(MON),Eosinophil count(EOS),Basophil count(BAS),Red cell distribution width CV(RDW-CV),Red cell distribution width SD(RDW-SD),Neutrophil lymphocyte ratio(NLR),derived Neutrophil lymphocyte ratio(dNLR),Platelet lymphocyte ratio(PLR),Monocyte lymphocyte ratio(MLR),Lymphocyte monocyte ratio(LMR),Red cell distribution width CV platelet count ratio(RPR),Red cell distribution width CV lymphocyte ratio(RLR),Eosinophil lymphocyte ratio(ELR))and coagulation related indexes(Prothrombin time(PT),Prothrombin time activity(PTa),International normalized ratio(INR),Fibrinogen(FIB),Activated partial thrombin time(APTT),Thrombin time(TT),D-Dimer(D-Di),Coagulation factor reaction time(R),Blood clot formation time(K),Blood clot formation rate(Angle),Maximum amplitude(MA),Percent lysis 30 min after MA(LY30),Estimate percent Lysis(EPL),Comprehensive coagulation index(CI),Blood clot strength(G),Real-time amplitude(A))were compared between the two groups.Use Excel to collect and sort out all data,and use SPSS 26.0 for statistical analysis.The comparison of differences between the two groups obeyed the normal distribution and was expressed by mean ±standard((?) ± s)deviation,which was analyzed by independent sample t-test.It does not obey the normal distribution and is represented by the median(lower quartile,upper quartile)[m(P25,P75)] and analyzed by nonparametric test.For correlation analysis,linear correlation is used for normal distribution,and Spearman rank correlation is used for non normal distribution.The difference was statistically significant(P < 0.05).Results:The analysis results of inflammatory related indexes in the five classifications of blood cells in the two groups showed that(6.89±2.30 VS 5.61±3.15,P < 0.05),MON(1.86±3.52 VS 0.47±0.15,P < 0.05),RDW-CV(20.07±13.37 VS 14.62±2.62,P < 0.05),RDW-SD(40.61±12.35 VS 48.17±8.58,P < 0.05)in HDCP group were higher than those in normal pregnancy group.PLR(132.73(97.62,172.67)VS190.97(108.72,242.24),P < 0.05)in HDCP group was lower than that in normal pregnancy group.There was no significant difference in WBC,LYM,EOS,BAS,NLR,dNLR,MLR,LMR,RPR,RLR and ELR between the two groups(P > 0.05).The results of coagulation phase + D-Dimer showed that there was no significant difference in PT,PTa,INR,FIB,APTT,TT,D-Di between the two groups(P > 0.05).The results of thromboelastogram(TEG)showed that the values of LY30 and EPL in HDCP group were lower than those in normal pregnancy group(P < 0.05).There was no significant difference in other TEG indexes such as R,K,Angle,MA,CI,G and A(P > 0.05).The results of correlation analysis showed that the inflammatory index RDW-CV was negatively correlated with fibrinolytic index LY30(r =-0.805,P =0.029 < 0.05)and EPL(r =-0.805,P = 0.029 < 0.05)in HDCP patients.Conclusion:In patients with hypertensive disorder complicating pregnancy,when RDW-CV increased,the fibrinolytic index LY30 and EPL decreased,suggesting that the inflammatory index RDW-CV has a certain predictive effect on fibrinolytic inhibition in patients with hypertensive disorder complicating pregnancy.The inflammatory index RDW-CV indicates the change of systemic fibrinolytic state in patients with hypertensive disorder complicating pregnancy,which can be used as a predictive index for the change and development of coagulation function in patients with hypertensive disorder complicating pregnancy,and provide data support for the prevention and treatment of hypertensive disorders complicating pregnancy.There is a close and complex internal relationship between inflammatory changes and fibrinolysis process in hypertensive disorder complicating pregnancy,which jointly promotes the occurrence and development of hypertensive disorder complicating pregnancy.In clinical work,we should pay more attention to the above three indicators in order to reduce the risk of thrombosis in hypertensive disorder complicating pregnancy and provide clues for more accurate prevention and treatment of HDCP.