D-二聚体、抗凝血酶Ⅲ活性及常规凝血指标在产后出血所致DIC中的临床价值  

The clinic value of D dimmer,anti thrombin Ⅲ activity and routine coagulation tests in disseminated intravascular coagulation caused by postpartum hemorrhage

作　　者：折瑞莲 苏放明 霍梅 周莉 

机构地区：[1]曁南大学第二临床医学院深圳市人民医院,广东深圳518001

出　　处：《海南医学》2007年第6期3-4,共2页Hainan Medical Journal

摘　　要：目的探讨定量检测血浆D-二聚体(D dimmer,D-D),抗凝血酶Ⅲ活性(anti thrombin Ⅲ activity,AT-Ⅲ:A)及常规凝血指标在产后出血所致DIC中的临床价值。方法根据产后出血量对37例产后出血患者进行分组:第1组22例,产后出血量500～800ml,第2组15例,产后出血量﹥800ml,选同期正常分娩产妇49例(产后出血<500ml)为对照组;定量检测3组产时D-D、AT-Ⅲ:A及常规凝血指标。结果与对照组相比,产时D-D明显升高,AT-Ⅲ:A降低于(P均<0.001);第2组的凝血酶原时间(prothrombin time,PT)、凝血时间(thrombin time,TT)、血浆活化部分凝血活酶时间(activated partial thromboplastin time,APTT)(P均<0.01)及D-D(P<0.001)升高,纤维蛋白原(fibrinogen,Fg)、血小板计数(platelet count,WPC)(P均<0.01)及AT-Ⅲ:A降低(P<0.001)。与第1组相比,第2组D-D升高,Fg、BPC及AT-Ⅲ:A降低(P均<0.01)。结论AT-Ⅲ:A及D-D比常规凝血指标变化灵敏,可早期诊断产后出血所致的DIC。Objective To appraise the clinic value of D dimmer,anti thrombin Ⅲactivity and routine coagulation tests in disseminated intravascular coagulation caused by postpartum hemorrhage. Methods D dimmer,anti thrombin Ⅲ activity and routine coagulation tests were measured in 37 women who were divided into two groups according to the quatity of hemorrhage （group 1,22 patients, intrapartum hemorrhage 500-800 ml; group 2,15 patients, intrapartum hemorrhage more than 800 ml） and 49 women with normal deliveries as control. Results Compared with the control group,anti thrombin m activity was significant decreased and D dimmer was significant increased in the group 1 （P〈0.001）. Prothrombin time, thrombin time, activated partial thromboplastin time（P〈0.01） and D dimmer （P〈0.001）were significant increased but platelet count, fibrinogen （p〈0.01） and anti thrombin m activity （p 〈0.001）were increased in group 2. Compared with the group 1, platelet count, fibrinogenand anti thrombin m activity were decreased and D dimmer was increased in the group 2 （P〈0.01）. Conclusions D dimmer and anti thrombin m activity are more sensitive than routine coagulation tests in early diagnosis of disseminated intravascular coagulation in postpartum hemorrhage.

关 键 词：产后出血 D-二聚体 抗凝血酶Ⅲ活性 弥漫性血管内凝血 

分 类 号：R714.461[医药卫生—妇产科学]