妊娠期D-二聚体、凝血系列、白细胞及血小板动态变化及临床意义  

The dynamic changes and clinical significance of D-dimer, blood coagulation series, white blood cell and platelet in pregnancy

作　　者：路静 张丽[1] 吕士玉 郭建壮 陈永新[1] 崔晓凤[1] 陈珠峰[1] LU Jing;ZHANG Li;LV Shi-yu(Department of Clinical Laboratory,Shandong Provincial Qianfoshan Hospital,Shandong Jinan 250014)

机构地区：[1]山东省千佛山医院检验科,山东济南250014

出　　处：《医学检验与临床》2017年第12期22-24,共3页Medical Laboratory Science and Clinics

基　　金：山东省医药卫生科技发展计划（2014WS0104,2016WS0479）资助.

摘　　要：目的：探讨妊娠期D-二聚体、凝血系列、白细胞及血小板的动态变化及临床意义。方法：选取2014年10月～2015年5月期间，在我院妇产科门诊就诊的288例健康妊娠期女性患者（按妊娠周期分为：早期妊娠组116例，中期妊娠组85例，晚期妊娠组87例；按妊娠年龄分为：≤30岁组166例，〉30岁组122例），选取同期年龄相匹配、健康查体非妊娠女性50例作为对照组，观察不同妊娠期D-二聚体水平（D-dimer，D-D）、凝血酶原时间（prothrombintime，PT）、活化部分凝血酶时间（activatedpartialthromboplastintime，APTT）、纤维蛋白原含量（fibrinogenFIB）、白细胞（whitebloodcell，WBC）及血小板（platelet，PLT）的变化。结果：妊娠组与正常对照组比较．PT、APTT时间缩短，PLT降低，FIB、D—D和WBC增高，差异有统计学意义（P〈0．05），中期妊娠和早期妊娠比较，FIB、D—D和PLT明显增加，差异有统计学意义（P〈O．05），PT、APTT、WBC无明显差异（P〉0．05）。晚期妊娠和中期妊娠比较，PT时间进一步降低，FIB、D—D增加，差异有统计学意义（P〈0．05），APTT、WBC、PLT无明显差异（P〈0．05）。晚期妊娠和早期妊娠比较，PT、APTT、PLT明显减少，FIB、D—D明显增加，差异有统计学意义，WBC无明显差异。妊娠年龄≤30岁和〉30岁女性的D—D、PT、APTT、FIB水平比较，差异无统计学意义（P〉0．05）。结论：妊娠期女性的D—D、PT、APTT、FIB与正常女性比较有显著性差异，且随着妊娠期的进展，FIB、D—D在体内含量逐渐增加，而PT、APTT逐渐降低；但升高或降低程度均与年龄无关。Objective： This study aims to explore the dynamic changes and clinical significance of D-dimer, blood coagulation series, white blood cell （WBC） , and platelets （PLT） during pregnancy. Methods： From October 2014 to 2015 May, 288 healthy pregnant women came from the obstetrics and gynecology clinic of our hospital were involved. According to pregnancy stage, the pregnant women were divided into three groups： early pregnancy group, middle pregnancy group and late pregnancy group. According to different age, the pregnant women were divided into two groups： less than or equal to 30 years group and older than 30years group. Age matching healthy non-pregnant women were selected as control group. D-dimer and prothrombin time （PT） , activated partial thromboplastin time （APTT） , fibrinogen （FIB） ,white blood cell （WBC） and platelets （PLT） were detected to analyze the changes and clinical significance. Results： Compared with the non-pregnant control group, PT, APTT and PLT in pregnancy shortened or decreased, while FIB, D-D and WBC increased, and the difference had statistically significant （P〈0.05） . Compared with early pregnancy group, FIB, D-D and PLT in middle pregnancy increased clearly （P〈0.05） ; while the difference ofPT, APTT and WBC were not clear. Between middle pregnancy group and late pregnancy group, PT in late pregnancy further shortened. FIB and D-D increased too. the difference of PT, APTT and WBC were not obvious. Between early pregnancy group and late pregnancy group, the variation tendency of the above indicators were similar. Between the less than or equal to 30 years group and the older than 30 years group, there were not significant difference of D-dimer, PT, APTT and fibrinogen （FIB） , （P〉0.05） . Conclusion： The levels ofD-dimer, PT, APTT and fibrinogen （FIB） in pregnant women were different from those of non-pregnant women. With the progress of pregnancy, D-dime and fibrinogen （FIB） increased, while PT and APTT decreased. But the

关 键 词：D-二聚体 妊娠 凝血酶原时间 纤维蛋白原 活化部分凝血酶时间 

分 类 号：R743.33[医药卫生—神经病学与精神病学]