妊娠晚期孕妇狼疮抗凝物检测血栓形成性疾病发生的临床意义  

Clinical significance of detection of thrombosis in pregnant women with late pregnancy

作　　者：孔万仲[1] 王怡 郭跃丽[1] 梁世周 林枝[1] 

机构地区：[1]浙江省温州市中医院检验科,浙江温州325000 [2]浙江省温州市中西医结合医院检验科,浙江温州325000

出　　处：《中国现代医生》2017年第12期144-146,共3页China Modern Doctor

基　　金：浙江省温州市科学技术局立项课题(Y20160513)

摘　　要：目的分析妊娠晚期孕妇狼疮抗凝物(lupus anticoagulant,LA)水平变化,探讨LA检测在妊娠晚期血栓形成性疾病中的临床意义。方法选取2015年12月~2016年12月在我院就诊或产前体检的118例妊娠晚期孕妇和120例健康育龄期妇女分别作为观察组和对照组;分别检测两组狼疮抗凝物比值(lupus anticoagulant ratio,LAR)、抗凝血酶Ⅲ(anticoagulantⅢ,ATⅢ)、D-二聚体(D dimer,D-D)、凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(fibrinogen,FIB)及进行血小板聚集试验(platelet agglutination test,PAg T)。结果与对照组比较,观察组的LAR、D-D、FIB和PAg T增高,PT和ATⅢ下降,PT时间缩短,差别有统计学意义(P均<0.05);以超过对照组平均值为阳性,观察组中的LAR、D-D及PAg T各指标阳性率明显高于FIB阳性率和PT阳性率。结论妊娠晚期孕妇LAR的升高与血栓前状态指标的变化相平行。在临床上,LA水平变化与血栓发生发展相关,可监测妊娠晚期血栓形成性疾病的发生。Objective To analyze the changes of lupus anticoagulant（LA） level in pregnant women with late pregnancy, and to explore the clinical significance of LA in detecting thrombotic disease in late pregnancy. Methods 118 cases of women with late pregnancy and 120 healthy women of childbearing age who were admitted or underwent prenatal examination in our hospital from December 2015 to December 2016 were selected as the observation group and the control group,respectively. The lupus anticoagulant ratio（LAR）, anticoagulant Ⅲ （ATm）, D dimer（D-D）, prothrombin time （PT）, activated partial thromboplastin time（AVFT） and fibrinogen（FIB） between the two groups were measured and platelet agglutination test（PAgT）was taken. Results Compared with those in ihe control group,The levels of LAR, D-D, FIB and PAgT were increased, PT and AT III decreased, and PT time was shortened in the observation group, the difference was statistically significant（P〈0.05）. It was positive when the mean in the observation group was more over that in the control group. The positive rates of LAR, D-D and PAgT in the observation group were significantly higher than that in FIB and PT. Conclusion The increase of LAR in women with late pregnancy is parallel to that of prethrombotic state. In clinical practice, changes in LA levels are related to the development of thrombosis ,which can monitor the occurrence of thrombotic disease.

关 键 词：狼疮抗凝物 妊娠晚期 血栓前状态 血栓形成性疾病 

分 类 号：R446.11[医药卫生—诊断学] R714.256[医药卫生—临床医学]