正常妊娠妇女与重度子痫前期患者止凝血功能的研究  

A study of coagulation and fibrinolytic function in normal pregnant women and severe preeclampsia patients.

作　　者：傅勤[1] 林建华[1] 

机构地区：[1]上海交通大学医学院附属仁济医院妇产科,上海200001

出　　处：《现代妇产科进展》2007年第9期657-660,共4页Progress in Obstetrics and Gynecology

摘　　要：目的：通过测定正常孕妇和重度子痫前期患者止凝血功能指标和分子标志物，从出凝血角度早期监测妊娠高血压疾病的发生。方法：2005年4月至2006年1月动态采集100例正常妊娠妇女孕10～14周、孕20～24周、孕30～34周和28例孕30～36周重度子痫前期患者外周血，检测止凝血功能指标：凝血酶时间（1Tr）、凝血酶原时间（PT）、纤维蛋白原（FIB）和止凝血分子标志物凝血酶原片断1＋2（Fl＋2）、凝血酶调节蛋白（TM）、纤溶酶原激活物抑制剂（PAI-2）、血栓素B2（TXB2）等。结果：（1）正常妊娠妇女随孕周增加TT、PT短，PAI-2、TXB2增加，Fl＋2妊娠晚期与妊娠中期相比呈增加趋势（P〈0，05），FIB和TM无统计学差异。（2）与正常妊娠晚期妇女相比，重度子痫前期患者TT延长，FIB减少；F1＋2、PAI-2、TXB2呈增加趋势（P〈0．01）。PT和TM无统计学差异。结论：止凝血功能指标可作为反映孕妇高凝状态的筛选指标，而止凝血分子标志物Fl＋2、PAI-2、TXB2可作为早期监测妊娠高血压疾病发生的敏感指标。Objective： To determine the coagulation and fibrinolytic function in normalpregnancy women and severe preeclampsia（PE） and to moniter the hypertensive disorder compli-cating pregnancy in the point of blood coagulation function, Methods：The blood samples were collected at 10 -14,20 -24,30 - 34 gestational weeks in 100 normal pregnancy women and in 28 severe PE patients at 30 - 36 gestational weeks respectively from April 2005 to Jan, 2006. Some variables were detected in both groups, which including thrombin time （TT）, prothrombin time （PT） , fibrinogen （ FIB ）, prothrombin fragmentl ＋ 2 （ F1 ＋ 2 ）, plasminogen activator inhibitor-2 （PAl-2）, thrombomodulin （TM） and thromboxane B2 （ TXB2 ）. Results： （ 1 ） The values of TT and PT were shorting,while PAI-2 and TXB2 were rising as pregnancy advanced in the normal preg- nancy women. F1 ＋2 were higher in the third trimester than that in the second trimester（P 〈0. 05 ）. FIB and TM had no difference. （2）The values of rlT was longer,FIB was lower,F1 ＋2,PAI- 2 and TXB2 were significantly higher in severe PE patients than in the same term of normal preg- nancy women （P 〈 0.05 ）. PT and TM had no difference. Conclusions： The normal pregnancy women are in hypercoagulation state with the variables of TT,PT and FIB;while the hypertensive disorder complicating pregnancy in the view of blood coagulation function is associated with marked variables of F1 ＋ 2 ,PAI-2 ,TXB2.

关 键 词：妊娠 子痫前期 心血管 凝血系统 纤溶系统 

分 类 号：R714.252[医药卫生—妇产科学]