血栓弹力图预测早期复发性流产的研究  

Thrombelastogram predicting early recurrent miscarriage

作　　者：王桂卿 付锦华[2] 毕淑娜[3] 李晓林[3] 刘莹[3] 范文文[3] 

机构地区：[1]莱西市人民医院产科,山东莱西266600 [2]潍坊市人民医院,山东潍坊261000 [3]青岛市市立医院妇科,山东青岛266071

出　　处：《中国妇幼健康研究》2016年第8期982-984,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的比较早期复发性流产（RSA）患者及正常妇女血栓弹力图参数的变化,为早期RSA诊断和治疗提供有效的检测指标。方法对62例RSA患者和72例正常生育期妇女进行孕前及孕后的血栓弹力图（TEG）检测,统计各组TEG参数及妊娠丢失率的差异。结果 RSA组与正常组相比,最大凝块振幅（MA）显著增高,差异有统计学意义（t=2.37,P〈0.05）,其余指标两组间差异无统计学意义（t值分别为1.62、1.16、1.64,P〉0.05）。早孕期,RSA治疗组与正常组的血栓弹力图各参数差异无统计学意义（t值分别为1.57、1.34、1.16、0.54,均P〉0.05）。RSA未治疗组MA值均显著高于正常组、RSA治疗组（t值分别为2.65、3.21,均P〈0.05）,且R值显著降低（t值分别为2.21、2.37,均P〈0.05）,其余参数每两组之间比较无显著性差异（t值0.45~1.57,均P〉0.05）。妊娠丢失率方面,正常组、RSA治疗组及未治疗组相比较,妊娠丢失率依次升高,两组间比较差异有统计学意义（χ2值分别为5.33、26.89、6.12,均P〈0.05）。结论血栓弹力图可在非妊娠时鉴别部分RSA的女性是否处在血栓前状态。在这样状态下未经治疗的RSA再次妊娠流产的风险增高。监测TEG有助于指导RSA高危患者行抗血小板治疗。Objective To investigate the changes of thrombelastograph（ TEG） between normal pregnant women and those who suffer from early recurrent spontaneous abortion（ RSA）,so as to provide efficient test index for early diagnosis and treatment of RSA. Methods Tests were performed to identify TEG of 72 cases of normal women and 62 cases of RSA before and after pregnancy respectively,and then data was collected and abortion rates were analyzed. Results Compared to the control group,the RSA group witnessed a significant increased maximum amplitude（ MA） with statistical significance（ t = 2. 37,P〈0. 05）,while the remaining parameters showed no obvious differences（ t value was 1. 62,1. 16 and 1. 64,respectively,all P〉0. 05）. In the early stage,there was no significant difference between RSA treatment group and the control group（ t value was 1. 57,1. 34,1. 16 and 0. 54,respectively,all P〉0. 05）. RSA in non-treatment group revealed an increased MA（ t value was 2. 65 and 3. 21,respectively,both P〈0. 05） but decreased R value（ t value was 2. 21 and2. 37,respectively,both P〈0. 05） compared to the control group and RSA treatment group,but the other parameters were not obviously different（ t value ranged 0. 45 to 1. 57,all P〈0. 05）. The abortion rate of the control group,RSA group and non-treatment group increased in order,and the difference between two groups was statistically significant（ χ2value was 5. 33,26. 89 and 6. 12,respectively,all P〈0. 05）. Conclusion TEG is able to identify whether some RSA patients being in pre-thrombotic state（ PST） in non-pregnant period. Under this condition,untreated RSA patients suffer an increased risk of abortion. Monitoring TEG is conducive to guide the antiplatelet therapy for high-risk patients of RSA.

关 键 词：复发性流产 血栓弹力图 血栓前状态 凝血功能 

分 类 号：R714.2[医药卫生—妇产科学]