The changes of hematological examination indexes and the incidence of pregnancy associated diseases in women with advanced maternal age in different periods of gestation
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摘要:目的 探讨高龄产妇不同妊娠时间段血液学检查指标变化及妊娠伴发疾病发生情况。方法 随机抽取行产前检查及分娩的高龄孕产妇100例, 作为研究组; 另抽取同期行产前检查及分娩的适龄孕产妇100例，作为对照组。2组均分别在孕早期、中期、晚期检测对比血液学检验指标，并统计妊娠伴发疾病发生情况。结果 孕中期、孕晚期时，研究组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、促甲状腺激素(TSH)水平显著高于对照组(P < 0.05), 高密度脂蛋白胆固醇(HDL-C)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)水平显著低于对照组(P < 0.05); 孕早期、孕中期、孕晚期时，研究组空腹血糖(FBG)水平显著高于对照组(P < 0.05); 研究组妊娠伴发疾病的发生率显著高于对照组(P < 0.05)。结论 高龄产妇妊娠期间需加强血液学指标检验，以指导孕期管理，控制妊娠伴发疾病的发生。Abstract:Objective To investigate the changes of hematological examination indexes and the incidence of pregnancy associated diseases in women with advanced maternal age in different periods of gestation.Methods A total of 100 delivery women with advanced maternal age who received prenatal examination in our hospital were randomly selected as the study group. A total of 100 delivery women with proper age in the same period in our hospital were selected as the control group. The hematology test indicators in the early, middle and late stages of pregnancy were detected and compared, and the incidence of pregnancy associated diseases was statistically analyzed.Results The triglyceride(TG), total cholesterol (TC), low density lipoprotein cholesterol(LDL-C) and thyroid stimulating hormone(TSH) levels in the study group were higher at middle and late stages of pregnancy than those in the control group (P < 0.05), and the levels of high density lipoprotein cholesterol(HDL-C), free tri-iodothyronine (FT3) and free thyroxine(FT4) were lower than those in the control group (P < 0.05). Fasting blood glucose(FBG) level in the study group was higher than that in the control group (P < 0.05). The incidence of pregnancy associated diseases in the study group was higher than that in the control group (P < 0.05).Conclusion Hematology index test should be strengthened to guide pregnancy management and control the occurrence of pregnancy associated diseases for advanced maternal age cases during pregnancy.
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表 1 2组妊娠不同时间段血液学检验指标对比(x±s)
指标 研究组(n=100) 对照组(n=100) 孕早期 孕中期 孕晚期 孕早期 孕中期 孕晚期 Hb/(g/L) 125.32±11.54 116.87±11.86 123.21±11.26 126.05±12.85 118.35±10.60 123.54±11.25 PLT/(×109/L) 152.06±42.80 150.65±38.14 153.58±48.24 150.36±42.80 145.62±40.55 155.40±45.05 WBC/(×109/L) 7.48±2.70 8.52±2.15 8.56±2.03 7.39±2.62 8.62±2.50 8.49±2.06 TC/(mmol/L) 6.34±1.02 6.72±0.98* 6.82±1.17* 6.29±0.82 6.49±0.78 6.50±0.81 TG/(mmol/L) 2.60±0.35 3.68±0.47* 4.15±1.12* 2.58±0.40 2.95±0.46 3.05±0.42 HDL-C/(mmol/L) 3.05±0.58 2.35±0.52* 2.20±0.38* 2.99±0.62 2.58±0.49 2.44±0.40 LDL-C/(mmol/L) 3.96±0.75 3.75±0.71* 3.45±0.95* 3.88±0.68 3.60±0.48 3.20±0.45 FBG/(mmol/L) 5.52±0.38* 4.35±0.54* 5.15±0.45* 4.05±0.41 3.68±0.52 3.22±0.48 TSH/(mU/mL) 2.45±0.60 3.54±0.78* 3.91±1.04* 2.46±0.57 2.62±0.18 2.61±0.15 FT3/(pmol/L) 3.55±0.70 2.70±0.41* 2.64±0.38* 3.56±0.62 3.60±0.68 3.62±0.54 FT4/(pmol/L) 14.26±2.14 12.05±1.22* 11.75±1.35* 14.25±2.05 14.30±1.85 15.32±1.80 Hb: 血红蛋白; PLT: 血小板; WBC: 白细胞计数; TC: 总胆固醇; TG: 甘油三酯; HDL-C: 高密度脂蛋白胆固醇; LDL-C: 低密度脂蛋白胆固醇; FBG: 空腹血糖; TSH: 促甲状腺激素; FT3: 游离三碘甲状腺原氨酸; FT4: 游离甲状腺素。与同时期对照组比较, *P < 0.05。 
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表 2 2组妊娠伴发疾病发生情况对比[n(%)]
组别 妊娠期甲状腺疾病 妊娠期糖尿病 妊娠期高脂血症 贫血 甲减 甲亢 合计 对照组 1(1.00) 1(1.00) 2(2.00) 2(2.00) 1(1.00) 3(3.00) 研究组 9(9.00)* 0 9(9.00)* 11(11.00)* 8(8.00)* 7(7.00) 与对照组比较, *P < 0.05。
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