月经过多女性出血倾向及止凝血功能状态的相关分析  

Relationship between bleeding diathesis and hemostatic defects in women with menorrhagia

作　　者：张海云[1] 马聪[1] 王蔼明[2] 沈建良[3] 赵强元[1] 马学斌[1] 陈昌国[1] 刘敏[1] 

机构地区：[1]海军总医院检验科,北京100048 [2]海军总医院妇产科 [3]海军总医院血液科

出　　处：《中国妇幼保健》2014年第9期1328-1331,共4页Maternal and Child Health Care of China

基　　金：国家科技部"十二五"科研支撑计划课题资助项目〔2012BAI32B05〕

摘　　要：目的:引入MCMDM-1vWD量表以评估月经过多女性的出血倾向,分析月经过多女性出血倾向与止凝血功能状态的关系。方法:以39例无妇科器质性病变的月经过多女性为研究对象,22例月经正常女性为对照,采集月经史,以MCMDM-1vWD量表评估出血倾向,并完成止凝血功能等相关检查。结果:月经过多女性中,有异常出血现象的人数、出血积分(BS)>0分的人数,均高于月经正常组。将月经过多及月经正常女性进一步分成不同出血积分亚组后发现,BS高分组(BS≥3)较BS低分组(BS≤0)经期天数更长、卫生巾用量更多,SI、MPV、Fib、vWF:Act、FVIII:C水平更低,PT更长。二分类Logistic回归分析发现,月经过多女性出血倾向增加(BS≥3)可能与PT延长有关。结论:无妇科器质性病变的月经过多女性中,有相当比例者出血事件多见,出血倾向较明显。以MCMDM-1vWD量表为工具进行出血倾向评估,可在一定程度上反映月经过多女性的止凝血功能状态,具有一定临床使用价值。Objective： To develop a Chinese version of MCMDM - 1vWD questionnaire, in order to evaluate bleeding diathesis of women with menorrhagia, and to analyze the correlation between their bleeding diathesis and hemostatic defects. Methods： Thirty - nine women with menorrhagia and normal pelvis examinations were selected as study objects, and twenty - two health female with normal menstruation were selected as control group. Complete blood cell count, serum iron, and hemostatic testing were measured. Menstrual information was collected. Bleeding history was quantitatively assessed by MCMDM - 1vWD questionnaire. Results： A relatively high proportion of women with unexplained menorrhagia was found to have abnormal bleeding symptoms and positive bleeding score （ BS 〉 0） compared to control group. Besides, women with higher bleeding scores （BS ≥3） experienced longer periods, consumed more menstrual products, and had lower SI, MPV, Fib, vWF- Act, FVIII： C levels but higher PT level, when compared to those with lower bleeding scores （BS≤0） . Logistic regression analysis showed that PT level might be an important influencing factor of higher bleeding diathesis （ BS≥3 ） of women with menorrhagia. Conclusion： Abnormal bleeding symptoms and higher bleeding diathesis are relatively prevalent in women with unexplained menorrhagia. Bleeding scores assessed by MCMDM - 1vWD questionnaire may be useful for hemostatic evaluation of these women.

关 键 词：月经过多 出血倾向 止凝血功能检查 

分 类 号：R711.51[医药卫生—妇产科学]