不同妊娠期孕妇及妊高征患者凝血四项指标变化的意义  

Clinical meaning on variation of coagulation indexes in normal pregnant and in patients with pregnancy induced hypertension

作　　者：时晓华[1] 于超[1] 徐成伟[1] 周勇[1] 徐永萍[2] 

机构地区：[1]山东大学第二医院检验科,济南250033 [2]山东大学第二医院妇产科,济南250033

出　　处：《医学检验与临床》2005年第5期39-40,38,共3页Medical Laboratory Science and Clinics

摘　　要：目的探讨正常妊娠妇女和妊高征患者凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶凝固时间(TT)及血浆纤维蛋白原(Fbg)等反映凝血功能4项指标的检测及临床意义。方法厌PT、APTT、TT测定为凝固法,Fbg测定为发色底物法,均在CulterACL-200全自动血凝仪上进行,试剂及定标血浆均为IL公司产品。结果妊娠中、晚期妇女与正常对照组或早期妊娠者比较,PT、APTT、TT时间明显缩短、Fbg含量明显增高,差异有显著性(P<0.05或P<0.01);妊高征组与晚期妊娠组比较,PT、APTT、TT时间进一步缩短,差异有显著性(P<0.05或P<0.01);Fbg水平明显增高,其中65例中、晚孕妇女中39例大于4g/L,占60%;58例中、重度妊高征组中有46例Fbg>4g/L,占80%,某妊高征患者最高Fbg达7.5g/L。结论妊娠各期及妊高征患者由于凝血功能增强、抗凝及纤溶功能减弱,出现所谓妊娠期高凝状态。这一妊娠期生理变化为产后快速有效止血提供了物质基础,但也是导致妊娠期血栓病形成的重要原因,并可能与多种产科疾患有关。妊娠期间检测凝血4项指标的变化对预防血栓形成并及时进行抗凝治疗有着关键的作用。Objective To evaluate the clinical signification of coagulation indexes prothrombin time(PT),activated partial thromboplastin time(APTT),plasma thrombin time(TT),fibrinogen(Fbg)in normal pregnancy women and in patients with pregnancy induced hypertension.Methods PT,APTT,TT were assayed using coagulation method,Fbg were determined by chromogenie substances,all the peremeters were finished by ACL-200 automated blood coagulation analyzer.Results PT,APTT,TT were significantly shorter and Fbg was higher in middle and later terms pregnancy women than that in normal women controls or early terms pregnancy women(P<0.05或P<0.01): Similar be that in patients with pregnancy induced hypertension than in later terms pregnancy women(P<0.05或P<0.01).Conclusion The normal pregancy women and patients with pregnancy induced hypertension have a much changes in coagulation system,showing a pregnancy-related hypercoagulate.state existing risks of thrombotic complication.Observation of PT、APTT、TT and Fbg is necessary.

关 键 词：凝血酶原时间 活化的部分凝血活酶时间 凝血酶凝固时间 血浆纤维蛋白原 高凝状态 

分 类 号：R446.1[医药卫生—诊断学]