妊娠期血凝指标的变化  

Changes of coagulation-related parameters in normal pregnant women

作　　者：杨春[1] 林其德[1] 林建华[1] 张为远[2] 傅勤[1] 梁阿娟[1] 

机构地区：[1]上海交通大学医学院仁济医院妇产科,上海200127 [2]首都医科大学北京妇产医院,北京100026

出　　处：《上海交通大学学报（医学版）》2008年第5期561-563,570,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：“十五”国家科技攻关计划(2004BA720A06-01)~~

摘　　要：目的分析正常妊娠妇女孕期血凝指标的变化规律。方法测定177例正常妊娠妇女在孕早、中、晚三期的血栓调节蛋白(TM)、血栓烷B2(TXB2)、凝血酶原片断1+2(F1+2)、纤维结合蛋白(Fn)、D-二聚体(D-D)、纤溶酶原激活抑制剂-2(PAI-2)水平;51例健康非孕妇女作为对照。结果妊娠妇女孕期血液中Fn、TM、F1+2、PAI-2和D-D水平均较非孕妇女显著升高(P<0.01或P<0.001);孕早期TXB2水平低于非孕妇女(P<0.01),至孕晚期显著高于非孕妇女(P<0.001);妊娠妇女血液中TXB2、PAI-2和D-D水平随孕周增加而升高(P<0.001);孕中、晚期TM和F1+2水平明显高于孕早期(P<0.01或P<0.05),孕中、晚期比较则无统计学差异(P>0.05);Fn浓度在整个孕期没有明显变化(P>0.05)。结论正常妊娠存在血小板活化增加、纤维蛋白溶解亢进、抗纤溶活性增加、血管内皮细胞损伤以及凝血/抗凝血的高水平动态平衡。Objective To analyze the rule of changes in coagulation-related parameters in normal pregnant women. Methods One hundred and seventy-seven normal pregnant women were selected, and blood samples were collected at three trimesters for the detection of concentrations of thrombomodulin （TM）, thromboxane B2 （TXB2） , prothrombin fragment 1 ＋ 2 （ F1 ＋ 2） , fibronectin （Fn） , D-Dimer （D-D） and plasminogen activator inhibitor-2 （ PAI-2 ）. Fifty-one healthy nonpregnant women were served as controls. Results The concentrations of Fn, TM, F1 ＋ 2, PAI-2 and D-D in normal pregnant women were significantly higher than those in the non-pregnant（ P 〈 0.01 or P 〈 0. 001 ）. The concentration of TXB2 was lower in the first trimester（P 〈0.01 ） and significantly higher in the third trimester（ P 〈 0. 001 ） than the nonpregnant. The concentrations of TXB2 , PAI-2 and D-D in normal pregnant women were increased with time of gestation（P 〈 0. 001）. The concentrations of TM and F1 ＋ 2 were higher in the second and third trimesters than in the first trimester（P 〈 0.01 or P 〈0.05） ,while there was no significant difference between the second and third trimester （P 〉0.05）. There was no significant change in the concentration of Fn with gestation （ P 〉 0.05）. Conclusion The activation of blood platelet, fibrinolysis, damage of vascular endothelial cells and coagulation/anti-coagulation are dynamicly balanced at a higher level in normal pregnancy.

关 键 词：妊娠 血栓调节蛋白 血栓烷 凝血酶原片断 纤维结合蛋白 D-二聚体 纤溶酶原激活抑制剂 

分 类 号：R714.25[医药卫生—妇产科学]