The Relationship Between ALT、GGT、LDH In Serum And The Outcomes Of Perinatal Fetus In Women With Severe Preeclampsia

Hypertensive disorder complicating pregnancy is a special disease during the period of pregnancy. Its primary symptom is transient hypertension and albuminuria. The symptom will disappear after delivery. It does harm to mother and fetus seriously. And it is the main reason that the morbidity and mortality of mother and fetus increasing. Especially severe preeclampsia, the prognosis of mother and fetus is worse. Therefore, it is significant to find the disease early.The essential change of the disease is that the small blood vessel of the whole body convulsing. The blood of each organ of the body decreasing. And it may hurt the organs irreversibly. The abnormal function of the organs may cause change of some serum indices. Therefore, by means of monitoring serum indices, we can find out the hurt it dose to organs of pregnant woman and perinatal outcomes.ObjectiveTo explore the significance of each item of serum indices in women with severe preeclampsia. It is hoped that, in future, doctors could forecast bad outcomes rapidly according to these indices and then intervene it right away. Methods1Object:(1) Experimental group:choose115cases of severe preeclampsia patients as object of study. They were treated in the Third Affiliated Hospital of Zhengzhou University from June2010to December2010.(2) Control group:choose117cases of normal pregnant women who matched as control group.They all have regular menstrual cycle, remember the last menstrual period clearly, single pregnancy, and have no other complication.2Methods:10ml venous blood on empty stomach in the early morning was collected. Do a routine blood test, coagulation analysis and hepatonephric function test using the blood. To compare white blood cell(WBC), red blood cell(RBC), hematocrit(HCT), platelet(PLT), plateletcrit(PCT), prothrombin time(PT), thrombin time(TT), fibrinogen(Fib), alanine aminotransferase(ALT), aspartate aminotransferase(AST), glutamyl transferase(GGT), total protein, albumin, bile acid, blood urea nitrogen, serum creatinine, uric acid and β2-microglobulin (βP2-MG) between the two groups. Meantime, to observe the relation between the level of lactate dehydrogenase(LDH) and pregnancy outcomes in women with severe preeclampsia.3Normal Reference:WBC(4-10)×109/L,RBC(3.5-5.5)×1012/L、HCT(37-50)%、PLT(100-300)×109/L、 PCT(0.108-0.282)%、PT(8.8-13.8)s、TT(12-18)s、Fib(2-4)g/L、ALT(0-31)U/L、 AST(0-31)U/L、GGT(0-35) U/L、 total protein (60-83)g/L、albumin(35-55)g/L、bile acid (0-10) μmol/L、blood urea nitrogen(2.5-8.2)mmol/L、serum creatinine (45-84) μmol/L、uric acid (150-360) μmol/L、β2-MG(1-3)mg/L、LDH (109-245)U/L。4Statistical Analysis:SPSS13.0software package was used to analyse all the data statistically. And α=0.05was considered as the inspection level. Results1The comparison of the common clinical data between the experimental group and the control group:the difference between the two groups in age, gravidity and delivery times has no statistic meaning (P>0.05)2The comparison of the routine blood indices between the experimental group and the control group:compared with the control group, the level of WBC and HCT in the experimental group is significantly higher, and the level of PLT and PCT in the experimental group is significantly lower (P＜0.05); but the level of RBC is similar between the two groups (P>0.05)3The comparison of the coagulation analysis indices between the experimental group and the control group:compared with the control group, the level of Fib in the experimental group is significantly higher, and the level of PT and TT in the experimental group is significantly lower (P＜0.05)4The comparison of the hepatonephric function indices between the experimental group and the control group:compared with the control group, the level of ALT, AST, GGT, bile acid, blood urea nitrogen, serum creatinine, uric acid and β2-MG in the experimental group is significantly higher, and the level of total protein and albumin in the experimental group is significantly lower (P＜0.05). The increasing of ALT and GGT is striking, which is more than twice as the control group.5The connection between ALT and perinatal outcomes:in the experimental group, the delivery pregnancy week, birth weight, one minute and five minutes Apgar score of pregnant woman whose ALT is above31U/L are all significantly lower than others (P＜0.05)6The connection between GGT and perinatal outcomes:in the experimental group, the delivery pregnancy week, birth weight, one minute and five minutes Apgar score of pregnant woman whose GGT is above35U/L are all significantly lower than others (P＜0.05)7The connection between LDH and perinatal outcomes:in the experimental group, the delivery pregnancy week, birth weight, one minute Apgar score of pregnant woman whose LDH is above245U/L are all significantly lower than others (P＜0.05). But five minutes Apgar score is similar (P>0.05) ConclusionsThe increasing of ALT、 GGT and LDH may result in bad perinatal outcomes.