妊娠合并血小板减少症的病因分析及对母婴结局的影响  

Etiological analysis of pregnancy complicated with thrombocytopenia and the effect on maternal and infantile outcomes

作　　者：杨敏[1] 郭志伟[1] 蒋婕[1] 

机构地区：[1]珠海市人民医院产科,广东珠海519000

出　　处：《中国妇幼保健》2017年第6期1155-1158,共4页Maternal and Child Health Care of China

摘　　要：目的探讨妊娠合并血小板减少症的病因及对母婴结局的影响。方法回顾性分析妊娠合并血小板减少症患者96例,并根据孕期血小板计数分为4组,Ⅰ组患者血小板计数为50×10~9~100×10~9/L,Ⅱ组患者血小板计数为30×10~9~50×10~9/L,Ⅲ组患者血小板计数为10×10~9~30×10~9/L,Ⅳ组患者血小板计数低于10×10~9/L。比较各组患者的疾病病因、妊娠期并发症及母婴分娩情况。结果 96例妊娠合并血小板减少症患者中,病因主要包括血小板减少症、特发性血小板减少性紫癜、妊娠期高血压疾病、再生障碍性贫血、系统性红斑狼疮,其中特发性血小板减少性紫癜、妊娠期高血压疾病在4组中发生率具有统计学意义(P<0.05);妊娠期高血压疾病、早产及产后出血在4组中的发生率具有统计学意义(P<0.05);4组围生儿足月低体重儿,颅内出血以及围生儿死亡率无统计学意义(P>0.05);4组间新生儿血小板减少发生率具有统计学意义(P<0.05),母体血小板数目越少,新生儿血小板减少发生率越高。结论妊娠合并血小板减少症病因复杂,且患者血小板数目越少,发生妊娠期高血压疾病、早产、产后出血及新生儿血小板减少比例越高。Objective To explore the causes of pregnancy complicated with thrombocytopenia and the effect on maternal and infantile outcomes.Methods Ninety-six pregnant women complicated with thrombocytopenia were analyzed retrospectively,then they were divided into four groups according to blood platelet count during pregnancy： groupⅠ（50×10^9/L-100×10^9/L）,group Ⅱ（30×10^9/L-50×10^9/L）,group Ⅲ（10×10^9/L-30×10^9/L）,group Ⅳ（10×10^9/L）.The causes,pregnancy complications,delivery situations in the four groups were compared.Results The main causes of thrombocytopenia included thrombopenia,idiopathic thrombocytopenic purpura,gestational hypertension,aplastic anemia,and systemic lupus erythematosus,there were statistically significant differences in the incidence rates of thrombocytopenic purpura and gestational hypertension among the four groups（P〉0.05）.There were statistically significant differences in the incidence rates of hypertensive disorder complicating pregnancy,premature delivery,and postpartum hemorrhage among the four groups（P〈0.05）.There was no statistically significant difference in the incidence rates of full-term low birth weight infants,intracranial hemorrhage and perinatal mortality among the four groups（P〈0.05）.There was statistically significant difference in the incidence rate of thrombocytopenia among the four groups（P〈0.05）.The lower platelet count was,the higher the incidence rate of neonatal thrombocytopenia was.Conclusion The etiology of pregnancy complicated with thrombocytopenia is complex.With the aggravation of thrombocytopenia in patients,the incidence rates of hypertensive disorder complicating pregnancy,premature delivery,postpartum hemorrhage and neonatal thrombocytopenia increase.

关 键 词：妊娠 血小板减少症 病因 母婴结局 

分 类 号：R714.254[医药卫生—妇产科学]