先兆流产妊娠结局与凝血纤溶指标的关系  

Relationship between threatened abortion and the outcome of coagulation and fibrinolysis

作　　者：赵雷[1] 姚丽艳[1] 朱晓玉[1] 孙业亮[1] 

机构地区：[1]新疆医科大学第二附属医院妇产科,新疆乌鲁木齐830063

出　　处：《中国医药导报》2016年第30期111-113,129,共4页China Medical Herald

摘　　要：目的探讨凝血纤溶指标与先兆流产妊娠结局的相关性。方法 选择2014年12月～2015年12月在新疆医科大学第二附属医院妇产科确诊为先兆流产患者78例,经治疗后有41例患者继续妊娠,为继续妊娠组;37例患者发展为难免流产,为难免流产组;另选取40例正常妊娠患者为对照组。检测并比较各组孕妇静脉血纤维蛋白原（Fbg）、D-二聚体（DD）和血小板（PLT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）水平差异。结果 难免流产组PLT、DD、Fbg水平明显高于继续妊娠组和正常妊娠组,差异有统计学意义（P〈0.05）;PT、APTT明显低于继续妊娠组和正常妊娠组,差异均有统计学意义（P〈0.05）。孕龄≥12周时,难免流产组患者DD、Fbg明显高于继续妊娠组,PT、APTT明显低于继续妊娠组,差异有统计学意义（P〈0.05）。与流产次数〈2次者比较,流产次数≥2次者PLT、DD、Fbg明显升高,APTT明显降低差异有统计学意义（P〈0.05或P〈0.01）,PT差异无统计学意义（P〉0.05）。结论 凝血纤溶失衡与先兆流产患者不良妊娠结局相关,其对先兆流产妊娠结局的影响主要发生在孕龄≥12周。复发性流产患者更容易出现凝血纤溶失衡。Objective To study the relationship between the blood coagulation fibrinolysis and threatened abortion outcomes. Methods From December 2014 to December 2015, 78 cases who were diagnosed as threatened abortion patients in the Second Affiliated Hospital of Xinjiang Medical University were selected, among those patients 41 cases of continue pregnancy after treated were set as the continue pregnancy group; and the other 37 patients developed inevitable abortion were set as inevitable abortion group. 40 cases of normal pregnancy were selected as control group. The levels of Fbg, DD, PLT, PT, APTT of each group were tested and compared. Results The levels of PLT, DD, Fbg in the inevitable abortion group were higher than those of the continuing pregnancy group and normal pregnancy group, the differences were statistically significant （P 〈 0.05）; the levels of PT, APTT in the inevitable abortion group were lower than those of the continuing pregnancy group and normal pregnancy group, the differences were statistically significant （P 〈 0.05）. At 12 weeks of gestation, the levels of DD and Fbg in the inevitable abortion group were higher than those of the pregnancy group, and levels of PT and APTT were decreased significantly, the differences were statistically significant （P 〈 0.05）. Compared with patients whose abortion times ≥ 2, levels of PLT, DD, Fbg in the patients with abortion times 〈 2 were increased significantly, APTT was significantly decreased, the differences were statistically significant （P 〈 0.05 or P 〈 0.01）, but there was no significant difference in PT between two groups （P 〉 0.05）. Conclusion The imbalance of coagulation and fibrinolysis is related to the adverse pregnancy outcome of threatened abortion patients, the influence mainly generate at pregnant woman with gestation age ≥ 12 weeks. Recurrent abortion patients are more prone to coagulation and fibrinolysis imbalance.

关 键 词：先兆流产 凝血纤溶 妊娠结局 

分 类 号：R714.21[医药卫生—妇产科学]