口服糖耐量试验与妊娠妇女血栓前状态关系的研究  

The Rel-ationships of Oral Glucose Tolerance Test and Pregnant Prothrombotic State

作　　者：孙曼妮[1] 陈海英[1] 孟涛[1] 

机构地区：[1]中国医科大学附属第一医院产科,沈阳110001

出　　处：《血栓与止血学》2010年第6期277-280,共4页Chinese Journal of Thrombosis and Hemostasis

基　　金：辽宁省博士科研启动;自然科学基金项目(20052094)

摘　　要：目的研究孕中期口服糖耐量试验(OGTT)与孕晚期血栓前状态的关系。方法 100例糖筛查异常孕妇(妊期24～28周)行75 g OGTT,分为正常糖耐量(NGT)组、妊娠糖耐量受损(GIGT)组和妊娠期糖尿病(GDM)组,计算糖耐量试验曲线下面积(AUC-OGTT),于分娩前测定血浆红细胞比积(HCT)、血小板数(PLT)、平均血小板体积(MPV)、凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)、纤维蛋白原(Fbg)、D-二聚体(D-D)和三酰甘油(TG)等8项血栓前状态参数,比较三组参数变化,将4段血糖值及AUC-OGTT分别与血栓前状态参数进行相关分析。结果 GDM组PLT、PT、aPTT显著小于NGT和GIGT组(P<0.05),而MPV、Fbg、D-D、TG显著大于NGT和GIGT组(P<0.05);GDM组HCT显著大于GIGT组(P<0.05);AUC-OGTT与HCT、MPV、Fbg、D-D、TG呈正相关,与PLT、PT、aPTT呈负相关,与血栓前状态异常参数的个数呈正相关。结论 OGTT异常的孕妇具有明显的血栓前状态,AUC-OGTT可作为预测孕晚期血栓疾病风险的一个指标。Objective To study the relationships of oral glucose tolerance test(OGTT) in second trimester and prothrombotic state in third trimester.Methods According to the results of 75 g-OGTT in pregnant 24～28 weeks,100 pregnant women with abnormal glucose screening were divided into three groups:normal glucose tolerance(NGT) group,gestational impaired glucose tolerance(GIGT) group and geatational diabetes mellitus(GDM) group,calculate area under curve of OGTT(AUC-OGTT).To detect partial prothrombotic state parameters before deliver,including hematocrit(HCT),platelet count(PLT),mean platelet volume(MPV),prothrobin time(PT),activated partial thromboplastin time(aPTT),fibrinogen(Fbg),D-Dimer(D-D) and triglyceride(TG),compare them among three groups,make correlation analysis between fasting、1h,2h,3h,AUC-OGTT and prothrombotic state parameters.Results In GDM group,PLT,PT,aPTT were significantly lower than in NGT and GIGT groups(P<0.05),while MPV,Fbg,D-D,TG were significantly higher than in NGT and GIGT groups(P<0.05);In GDM group,HCT was significantly higher than in GIGT groups(P<0.05);AUC-OCTT had positive correlations with HCT,MPV,Fbg,D-D and TG,but had negative correlations with PLT,PT and aPTT,moreover AUC-OGTT had positive correlation with number of abnomal parameters.Conclusion Pregnant women with abnormal OGTT had obvious prothrombotic state,AUC-OGTT could predict risk of thrombosis in third trimester.

关 键 词：口服糖耐量试验 妊娠妇女 血栓前状态 状态关系 活化部分凝血活酶时间 OGTT 状态参数 平均血小板体积 正相关 孕晚期 妊娠期糖尿病 凝血酶原时间 aPTT 正常糖耐量 纤维蛋白原 糖筛查异常 糖耐量受损 曲线下面积 红细胞比积 PLT 

分 类 号：R[医药卫生]