血栓弹力图应用于使用促排卵药物的体外受精-胚胎移植前患者血液凝血状态评价  

Effect of TEG on the evaluating of blood coagulating status in IVF-ET patients

作　　者：马怡然[1] 胡淑敏 王玉婷[1] 王光敏[1] 郝一文[1] 

机构地区：[1]中国医科大学附属第一医院输血科,辽宁沈阳110001 [2]沈阳市二○四医院辅助生殖中心

出　　处：《中国输血杂志》2013年第1期37-40,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨外源性促性腺激素行控制性超促排卵后行体外受精-胚胎移植术前患者血液凝血状态及血栓形成风险。方法 103名应用促排卵药物促性腺激素释放激素激动剂(GnRHa)后拟行体外受精-胚胎移植患者,按GnRHa用量分为:观察1组(GnRHa 1.25 mg,n=35)、观察2组(GnRHa 1.875 mg,n=35)及观察3组(GnRHa3.75 mg,n=33);以56名健康非妊娠妇女作为对照组。对4个组作产前凝血4项(PT、APTT、TT、Fib)检测,同时作血栓弹力图(TEG)检测,比较分析2种检测结果。结果凝血4项试验检测中,观察1、2、3组及对照组的PT(s)分别为9.1±1.6、7.2±1.2、6.2±0.9和12.2±1.2(P<0.05)。TEG检测,观察1、2、3组及对照组的R值(min)分别为4.6±1.8、4.2±3.2、3.2±3.2和6.2±1.2;CI值分别为1.2±0.7、1.6±0.2、3.6±2.7和-0.85±0.8(P<0.05);TEG检测参数K值与PT呈正相关,Angle角、MA值、G值及CI值与PT呈副相关;TEG检测参数Angle角与Fib呈正相关;观察1、2、3组用药前R值(min)分别为8.2±1.1、7.6±1.2、7.9±2.2,用药后R值(min)分别为4.6±1.8、4.2±3.2、3.2±3.2,(P<0.05)。结论 TEG可动态观察应用促排卵药物行体外受精-胚胎移植术前患者体内凝血状态,能及时了解体内凝血状况,对预防应用促排卵药物引起的卵巢过度刺激综合征的并发症血栓栓塞具有一定临床意义。Objective To study the blood coagulation station and thrombosis risk of controlled ovarian hyperstimulation for In Vitro Fertilization Pre-Embryo Transfer （IVF-ET） in patients. Methods A total of 103 patients for pre-IVF-ET were divided into 3 groups including the 1st observation group （ GnRHa 1.25 rag, n = 55 ）, the 2nd observation group （ GnRHa 1. 875 mg, n = 35 ） and the 3rd observation group （ GnRHa 3.75 mg, n = 33 ） by according the dose of GnRHa（ gonadotropin- releasing hormone analog, GnRHa）, and 56 healthy non-pregnant women as the control group.The 4 blood coagulation indexes as prothrombin time （ PT ） ; activated partial thromboplastin time （ APTT）, thrombin time （ TT）, fibrinogen （ Fib ） and （ throm- belastography , TEG）were tested and analyzed for 4 groups. Results For the 4 blood coagulation indexes, PT value in the 1 st, 2nd,3rd observation group and the control group respectively was 9. 1 ± 1.6, 7.2 ± 1.2, 6. 2 ±0. 9, and 12.2±1.2,the PT value among the three observation groups, and between the control group and the three observation groups were statistically significant difference （P 〈 0. 05）. For TEG, R value in the 1 st, 2nd,3rd observation group and the control group was 4. 6 ±1. 8,4. 2 ±3. 2,3.2 ± 3.2 , and 6. 2±1.2 , respectively, CI value was 1.2±0. 7,1.6±0. 2,3. 6± 2.7, and - 0. 85± 0. 8, respectively, the R value among the 3 observation groups, and between the control group and the three observation groups were statistically significant difference（ P 〈 0. 05）. The 3rd observation group, and the 1 st and 2nd observation groups were statistically significant difference for CI value （ P 〈 0. 05 ） ; K value was positively correlated with PT, while Angle （ ° ）, MA, G, and CI value negatively correlated with PT, Angle（°） positively correlated with Fib; R value in the 1 st, 2nd, and 3rd obser- vation group was 8. 2 ± 1.1,7. 6 ±1.2,7.9±2. 2, respectively before using GnRHa, and was 4. 6 ±1.8,4.2±3.2,3.2± 3.2, res

关 键 词：血栓弹力图 促性腺激素释放激素激动剂 体外受精 胚胎移植 凝血状态 凝血试验 

分 类 号：R446.11[医药卫生—诊断学] R711.6[医药卫生—临床医学]