摘要
目的:探讨研究不同孕期产妇的凝血四项、D-二聚体、血栓弹力图检测结果及其相关的临床意义,为患者的临床诊断提供指导。方法:选取2018年1月~2019年12月于我院进行产前检查的210例孕产妇作为研究对象。根据产妇的孕期将其分为早期组、中期组和后期组,同时选取100例健康的非妊娠女性作为对照组。对参与研究的产妇和健康女性进行血样采集,检测并对比不同孕期产妇及健康女性间凝血四项、D-二聚体、血栓弹力图(TEG)的差异及其意义。结果:妊娠组孕产妇的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)较对照组妇女显著较低;妊娠组孕产妇的纤维蛋白原(FIB)、D-二聚体水平较对照组妇女显著较高。从不同妊娠时期的凝血指标情况来看,处于中晚期妊娠的产妇其PT、APTT、TT均显著低于早期妊娠产妇,差异均具有统计学意义;处于中晚期妊娠的产妇其FIB、D-二聚体水平均显著高于早期妊娠产妇,差异均具有统计学意义。妊娠组孕产妇的血块形成速度(α角度)、反应血凝块绝对凝聚强度(MA)、综合凝血指数(CI)均显著高于对照组妇女;妊娠组孕产妇的凝血反应时间(R)、凝血形成时间(K)、MA确定后30 min纤维蛋白溶解率(LY30)均显著低于对照组妇女。从妊娠不同时期的TEG各项指标来看,处于中晚期妊娠的产妇其R、K、LY30均显著低于早期妊娠产妇;处于中晚期妊娠的产妇其α角度、MA、CI均显著高于早期妊娠产妇,差异均具有统计学意义。孕产妇的PT与MA呈高度正相关关系;APTT与R呈高度正相关,与MA呈低度负相关;TT与MA呈高度正相关;FIB与MA呈低度正相关;D-二聚体与R呈高度正相关,与MA呈高度正相关。结论:对孕产妇进行及时规范的凝血四项、D-二聚体和血栓弹力图检测,能够有效监测孕产妇在不同孕期凝血功能的状况和变化,同时对中晚期妊娠妇女的深静脉血栓和凝血功能障碍具有全面的预警作用,具有较好的临床运用价值。
Objective To explore and study the results of coagulation,D-dimer and thromboelastography in different pregnant women and their clinical significance,so as to provide guidance for patients’clinical diagnosis.Methods A total of 210 pregnant women who underwent prenatal examination in our hospital from January 2018 to December 2019 were selected as the research subjects.The pregnant women were divided into early group,middle group and late group according to their pregnancy.At the same time,100 healthy non-pregnant women were selected as the control group.Blood samples were collected from the participating women and healthy women,and the differences and significance of the four coagulation,D-dimer,and thromboelastography(TEG)differences between pregnant women and healthy women were detected and compared.Results After testing,the prothrombin time(PT),activated partial thromboplastin time(APTT),and thrombin time(TT)of pregnant women in the pregnancy group were significantly lower than those in the control group.The levels of fibrinogen(FIB)and D-dimer in the pregnant group were significantly higher than those in the control group.From the perspective of coagulation indicators in different pregnancy periods,PT,APTT,and TT of pregnant women in middle and late pregnancy were significantly lower than those of early pregnant women.The levels of FIB and D-dimer in pregnant women in middle and late pregnancy were significantly higher than those in early pregnant women,and the differences were statistically significant.The blood clot speed(αangle),maximum amplitude(MA),and synthetic blood clotting index(CI)of the pregnant women in the pregnancy group were significantly higher than those in the control group.The coagulation reaction time(R),clotting time(K),and MA determine the rate of 30 min after fibrinolysis(LY30)of pregnant women in the pregnancy group were significantly lower than those in the control group.From the TEG indicators in different periods of pregnancy,the R,K,and LY30 of pregnant women in middle and late pregnancy were significantly lower than those of early pregnant women,and the differences were statistically significant.The alpha angle,MA,and CI of pregnant women in middle and late pregnancy were significantly higher than those of early pregnant women.There was a highly positive correlation between maternal PT and MA.APTT was highly positively correlated with R and lowly negatively correlated with MA.TT was highly positively correlated with MA.FIB had a low positive correlation with MA.D-dimer was highly positively correlated with R and highly positively correlated with MA.Conclusion The timely and standardized detection of four coagulation tests,D-dimers,and thromboelastography in pregnant women can effectively monitor the status and changes of coagulation function of pregnant women in different stages of pregnancy,at the same time,it has a comprehensive early warning effect on deep vein thrombosis and coagulation dysfunction in middle and late pregnant women,which has good clinical application value.
作者
黄小慧
Huang Xiao-hui(Obstetrics Department,Hainan Women’s and Children’s Medical Center,Haikou 571100,China)
出处
《湖南师范大学学报（医学版）》
2021年第5期187-191,共5页
Journal of Hunan Normal University(Medical Sciences)
作者简介
通讯作者:黄小慧,E-mail:1139111238@qq.com
